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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073409283
Report Date: 03/28/2024
Date Signed: 03/28/2024 03:57:12 PM

Document Has Been Signed on 03/28/2024 03:57 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND CC RO, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME:VIJEH, MAHTABFACILITY NUMBER:
073409283
ADMINISTRATOR:VIJEH, MAHTABFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(925) 642-8306
CITY:PLEASANT HILLSTATE: CAZIP CODE:
94523
CAPACITY: 14TOTAL ENROLLED CHILDREN: 7CENSUS: 6DATE:
03/28/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Mahtab Vijeh TIME COMPLETED:
04:15 PM
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On 3/28/24 Licensing Program Analysts (LPAs) Brindha Govindasamy and
Monica Mathur conducted an unannounced annual inspection for Mahtab Vijeh's large family childcare home. LPA met with licensee and toured the facility. During today's inspection, there were 6 children in care (2 preschoolers and 4 infants). Also present during inspection was licensee's daughter who is her helper. Residing in the home are licensee and her adult daughter. All adults have Criminal Record Clearance. Facility hours of operations are Monday - Friday
8:00 AM - 5:30 PM.

This is a Single story home that comprises of 2 bedrooms, 2 bathrooms, Kitchen, Living/ Play area, Dining/Play area, Office, Detached Garage, Backyard, Left & Right Side Yard
Areas used for day care: Living, Dining, Kitchen, 2 Bedrooms, 2 Bathrooms, Backyard, Left Side Yard
Off-Limit Areas: Detached garage, outdoor storage shed, Right Side Yard, Office room.
Isolation Area: Dining/Play area

Outdoor Space: LPA toured the outdoor areas. Children will be using the Main Yard and Left Side Yard. The yard has fences on all sides. There is a flowing creek behind the backyard, with no access from the home. Fences are high enough and creek is completely inaccessible. Detached Garage and Storage shed in the yard is locked.

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SUPERVISORS NAME: Sherelle Johnson
LICENSING EVALUATOR NAME: Brindha Govindasamy
LICENSING EVALUATOR SIGNATURE: DATE: 03/28/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/28/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND CC RO, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME: VIJEH, MAHTAB
FACILITY NUMBER: 073409283
VISIT DATE: 03/28/2024
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Areas accessible to children were inspected to ensure that they are clean and orderly with ventilation and central heating system for safety and comfort. There were safe toys, play equipment and materials observed for children. There is a working telephone in the home. Detergents, poisons, cleaning compounds, medications, and other items which can pose a danger to children are made inaccessible in the home. Door access to off limit areas are locked. LPA reminded that smoking, baby walkers, bouncers, jumpers and similar items are not allowed in family childcare homes. Licensee does not have pets, no arms and ammunition in the home. Licensee has a 2A10BC fire extinguisher and working smoke/carbon monoxide detectors. Licensee last conducted fire drill 3/24. LPA reminded licensee when outside of facility, 100% supervision of children in care is required.

Children and staff records were reviewed. Licensee's Pediatric First Aid and CPR certificate will expire in 8/24. Licensee's Mandated Reporter certificate will expire 7/25. Required postings were observed near the entrance.

LPA reminded licensee day care needs to be operated within the limitations and capacity of a Large Family Child Care Home with regards to ratios and that Licensee must be present in the day care for 80% of the operation hours.



LPA discussed the safe sleep regulations with licensee [or facility representative] and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep as an additional resource. LPA also informed licensee [or facility representative] of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02CCP. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: https://www.ada.gov/resources/child-care-centers/.


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SUPERVISORS NAME: Sherelle Johnson
LICENSING EVALUATOR NAME: Brindha Govindasamy
LICENSING EVALUATOR SIGNATURE:

DATE: 03/28/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/28/2024
LIC809 (FAS) - (06/04)
Page: 2 of 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND CC RO, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME: VIJEH, MAHTAB
FACILITY NUMBER: 073409283
VISIT DATE: 03/28/2024
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Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain childcare by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California. During the exit interview, Licensee confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

In the areas that were evaluated, there were no violation observed. Exit interview conducted and report was reviewed with the Licensee, Mahtab Vijey. A notice of site visit was given and must remain posted for 30 consecutive days.

SUPERVISORS NAME: Sherelle Johnson
LICENSING EVALUATOR NAME: Brindha Govindasamy
LICENSING EVALUATOR SIGNATURE:

DATE: 03/28/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/28/2024
LIC809 (FAS) - (06/04)
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