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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 195700224
Report Date: 05/20/2025
Date Signed: 05/20/2025 03:59:53 PM

Document Has Been Signed on 05/20/2025 03:59 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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:NABIYEV FAMILY CHILD CAREFACILITY NUMBER:
195700224
ADMINISTRATOR/
DIRECTOR:		AYAZ NAMIYEVFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(818) 448-6776
CITY:RESEDASTATE: CAZIP CODE:
91335
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 6DATE:
05/20/2025
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:33 AM
MET WITH:Valeria Quiros, AssistantTIME VISIT/
INSPECTION COMPLETED:
02:00 PM
NARRATIVE
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On 05/20/2025 10:30 AM, Licensing Program Analysts (LPAs) Elicia Calvillo and Lilia Hernandez conducted an unannounced Case Management -Deficiencies visit. LPAs identified self and met with Valerie Quiros, Assistant, who guided LPAs on a tour of the inside and outside of the facility. LPAs bserved 2 infants and 4 preschool age children in care. Upon arrival Ayaz Nabiyev, Licensee was not present at the beginning of the visit and arrived approximately 01:30 PM. LPAs were later met by Sarkin (Alex) Nabiyev, Administrator and 1 additional assistant arrived.

Per the Assistant, upon opening the facility at 06:55AM the Licensee was not present.



Per Title 22, Division 12, Chapter 3 of the California Code of Regulations, Section 102417 (a) Operation of a Family Child Care Home, the licensee shall be present in the home and shall ensure that children in care are supervised at all times. When circumstances require the licensee to be temporarily absent from the home, the licensee shall arrange for a substitute adult to care for and supervise the children during his/her absence. Temporary absences shall not exceed 20 percent of the hours that the facility is providing care per day.

The purpose of today’s visit was to issue citations for deficiencies that were observed during a Case Management -Deficiencies visit on 05/14/2025, which LPA Calvillo was unable to finish due to time constraints.

On 05/14/2025, Saliy Gonzalez, who was identified as an Assistant at the facility, did not obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in the licensed Family Child Care Home.

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NAME OF LICENSING PROGRAM MANAGER: Rita Ramos
NAME OF LICENSING PROGRAM ANALYST: Elicia Calvillo
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 05/20/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/20/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: NABIYEV FAMILY CHILD CARE
FACILITY NUMBER: 195700224
VISIT DATE: 05/20/2025
NARRATIVE
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 On 05/14/2025, Valeria Quiros, who was also identified as an Assistant at the facility, did not obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in the licensed Family Child Care Home.

All adults 18 and over living in the home, persons who provide care and supervision to children, and staff who have contact with children, including employees and volunteers 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.

Saliy Gonzales and Valeria Quiros were also present and providing care without a current first aid and CPR certificate on file.

On 05/14/2025 at 09:46 AM, during the tour of the facility, LPA Calvillo observed Child #1, in a bedroom with the door closed that was in a not accessible part of the facility, an infant asleep in a car seat and swaddled in a blanket (photos taken). LPA advised Valerie Quiros, Assistant that the sleeping infant needs to be moved to the crib/pack n play in the Sleeping Room (photo taken). LPA advised Ayaz Nabiyev, Licensee that children in a child care facility shall not be swaddles while in care and that car seats shall only be used for transportation purposes and shall not be used for sleeping.

Per Title 22, Division 12, Chapter 3 of the California Code of Regulations, Section102425 (f) Infant Safe Sleep an infant shall not be swaddled while in care and Section 102425 (h) Infant Safe Sleep a car seat shall only be used for transportation purposes and shall not be used for sleeping.

During today's visit, per Title 22, Division 12, Chapter 3, of the California Code of Regulations, there are four (4) Type A citations being cited for sections 102370 (d)(2) Criminal Record Clearance with a $1,000.00 Civil Penalty and a Plan of Correction (POC) due date of 05/21/2025, 102416 (C) Personnel Requirements with a POC due date of 05/21/2025, 102425 (f) INFANT SAFE SLEEP with a POC due date of 05/21/2025, 102425 (h) INFANT SAFE SLEEP with a POC due date of 05/21/2025.

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NAME OF LICENSING PROGRAM MANAGER: Rita Ramos
NAME OF LICENSING PROGRAM ANALYST: Elicia Calvillo
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 05/20/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/20/2025
LIC809 (FAS) - (06/04)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: NABIYEV FAMILY CHILD CARE
FACILITY NUMBER: 195700224
VISIT DATE: 05/20/2025
NARRATIVE
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LPA informed the Licensee to provide a copy of this licensing report dated 05/20/2025 that documents four (4) Type A citation(s) to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224) (LPA provided a copy of the form), or other written statement, must be placed in the child's file for verification.

A Notice of Site Visit was given and must remain posted for 30 days during the hours of operation after each site visit by a licensing representative. Failure to comply with posting requirement will result in an immediate civil penalty of $100.00.

Exit interview was conducted with Ayaz Nabiyev, Licensee but not limited to Provider Rights, Appeal Procedures and Agencies Consultative Role.

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NAME OF LICENSING PROGRAM MANAGER: Rita Ramos
NAME OF LICENSING PROGRAM ANALYST: Elicia Calvillo
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 05/20/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/20/2025
LIC809 (FAS) - (06/04)
Page: 6 of 6
Document Has Been Signed on 05/20/2025 03:59 PM - It Cannot Be Edited


Created By: Elicia Calvillo On 05/20/2025 at 02:39 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: NABIYEV FAMILY CHILD CARE
FACILITY NUMBER: 195700224

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/20/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
05/21/2025
Section Cited
CCR
102370(d)(2)

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102370 (d)(2) Criminal Record Clearance (d) All individuals...shall prior to working, residing, or volunteering...(2) Request a transfer of a criminal record clearance...
This requirement is not met as evidenced by:
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Licensee stated that on 05/16/2025 they complete a criminal record clearance transfer for Saliy Gonzalez and Valeria Quiros. LPA confirmed that both criminalt record clearances were submitted.
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Based on observation, interview, record review, the licensee did not comply with the section cited above in that Staff #1 & Staff #2 did not have a criminal record clearance readily available upon request which poses an immediate health, safety or personal rights risk to persons in care.
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Type A
05/21/2025
Section Cited
CCR102416(C)

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102416 (C ) Personnel Requirements
(c) ...personnel ... complete training on preventive health practices, including pediatric cardiopulmonary resuscitation and pediatric first aid,....
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Licensee stated that on 05/16/2025 Pediatric CPR/First Aid was completed for Saliy Gonzalez and Valeria Quiros. LPA obtained copies of Pediatric CPR/First Aid completion certificates.
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Based on observation, interview, record review, the licensee did not comply with the section cited above in that Staff #2 did not have a Pediatric CPR/First Aid completion certificate readily available upon request which poses an immediate health, safety or personal rights risk to persons in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Rita Ramos
NAME OF LICENSING PROGRAM MANAGER:
Elicia Calvillo
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 05/20/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/20/2025


LIC809 (FAS) - (06/04)
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Document Has Been Signed on 05/20/2025 03:59 PM - It Cannot Be Edited


Created By: Elicia Calvillo On 05/20/2025 at 02:51 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: NABIYEV FAMILY CHILD CARE
FACILITY NUMBER: 195700224

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/20/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
05/21/2025
Section Cited
CCR
102425(h)

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102425 (h) INFANT SAFE SLEEP
(h) Car seats shall only be used for transportation purposes and shall not be used for sleeping.

This requirement is not met as evidenced by:
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Licensee stated they will no longer allow children to sleep in a car seat and a child will be removed from the child from the car seat as soon as the arrive at the facility. Licensee and staff will review the Infant Safe Sleep regulations and the CDSS video. And will provide LPA with a documentation by the plan of correction due date 05/21/2025.
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Based on observation, interview, record review, the licensee did not comply with the section cited above in that Child #1 was found asleep in a car seat while in care at the facility which poses an immediate health, safety or personal rights risk to persons in care.
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Type A
05/21/2025
Section Cited
CCR102425(f)

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102425 (f) INFANT SAFE SLEEP
(f) An infant shall not be swaddled while in care.
This requirement is not met as evidenced by:
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Licensee stated they will no longer allow swaddle children in care. Licensee and staff will review the Infant Safe Sleep regulations and the CDSS video. And will provide LPA with a documentation by the plan of correction due date 05/21/2025.
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Based on observation, interview, record review, the licensee did not comply with the section cited above in that Child #1 was found asleep while being swaddled in care at the facility which poses an immediate health, safety or personal rights risk to persons in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Rita Ramos
NAME OF LICENSING PROGRAM MANAGER:
Elicia Calvillo
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 05/20/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/20/2025


LIC809 (FAS) - (06/04)
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