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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 195700224
Report Date: 09/19/2025
Date Signed: 09/19/2025 02:41:26 PM

Document Has Been Signed on 09/19/2025 02:41 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: 8DATE:
09/19/2025
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:38 AM
MET WITH:Licensee Ayaz NabiyevTIME VISIT/
INSPECTION COMPLETED:
02:50 PM
NARRATIVE
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On 9/19/25, Licensing Program Analyst (LPA) Jeanine Lipsey conducted an unannounced Case Management - Deficiencies visit. Census 8 children in care being supervised by 3 adults. Staff did not know where the licensee was. Licensee arrived at the home at 9:48am. Licensee stated they were at the grocery store. Licensee did not return with groceries but stated they picked up a sandwich. Licensee was not present when LPA arrived on previous dates of 5/15/25, 7/20/25 and 9/4/25. Licensee left the home while LPA went on a 20 minute break.

At 11:20 am LPA observed 4 children sitting in high chairs watching TV while the other children sat on the floor in front of the TV. One child fell asleep and at 11:25am was taken out to be put in bed. At 11:45 LPA noticed a child put their feet on the wall and almost tip the high chair over. LPA advised the staff to remove the children immediately from the high chairs and explained to them what LPA saw. LPA advised that high chairs should be for feeding only and when a child falls asleep they must be taken out of the chair right away.

LPA observed the home to have a sign outside of the home with License number 197493132. Licensee explained the sign was from previous day care that they owned. Licensee stated they were aware of the incorrect number on the sign and had plans to correct it by next week. Licensee disclosed they were told previously regarding the sign but was too busy to fix it.

The number provided to the department belongs to licensee's brother. LPA advised the childcare number must be of the licensee and must remain in the home during childcare hours.

NAME OF LICENSING PROGRAM MANAGER: Betty Bell
NAME OF LICENSING PROGRAM ANALYST: Jeanine Lipsey
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 09/19/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/19/2025
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 5
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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Document Has Been Signed on 09/19/2025 02:41 PM - It Cannot Be Edited


Created By: Jeanine Lipsey On 09/19/2025 at 12:34 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: 09/19/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/26/2025
Section Cited
CCR
10242(a)(2)

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Personal Rights:
Each child shall be accorded safe, healthful and comfortable accommodations, furnishing and equipment.
This requirement is not met as evidence by:
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Effective immediately, Licensee agrees to not leave children on a high chair while not eating, and submit a written statement indicating plan of correction with the proper use of high chairs to the Department by 9/26/25.
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Based on LPA observation, 4 children where observed sitting in high chairs watching tv and sleeping, not eating. LPA observed 1 child almost tip the high chair over with its foot against the wall which poses/posed a potential health, safety or personal risk to children in care.
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Type B
09/26/2025
Section Cited
CCR102359(a)

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Advertisements and License Number
Licensees shall reveal each facility license number in all advertisements, publications...

This requirement is not met as evidence by:
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Per licensee the sign will be corrected by POC date of 9/26/25. Licensee will send proof of correction via email.
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Based on observation, LPA observed a sign in the front yard with a license number that is not the correct license number of the child care home, which poses/posed a potential health, safety or personal risk to children 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.
Betty Bell
NAME OF LICENSING PROGRAM MANAGER:
Jeanine Lipsey
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 09/19/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/19/2025


LIC809 (FAS) - (06/04)
Page: 3 of 5
Document Has Been Signed on 09/19/2025 02:41 PM - It Cannot Be Edited


Created By: Jeanine Lipsey On 09/19/2025 at 01:37 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: 09/19/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/26/2025
Section Cited
CCR
102417(a)

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Operation of Family Child Care Home
The licensee shall be present in the home...Temporary absences shall not exceed 20 percent of the hours that the facility is providing care per day. This requirement is not met as evidence by:
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Licensee will write a statement explaining the importance of the licensee being present during childcare hours and send to LPA by 9/26/25.
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Based on observation, Licensee was not home when LPA arrived at 8:34am. Licensee arrived at 9:38am, which poses/posed a potential health, safety or personal risk to children in care.
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Type B
09/26/2025
Section Cited
CCR102417(c)

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Operation of A Family Child Care Home
The home shall maintain telephone service.

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Licensee will submit new application with update to the phone to the department and the working phone will remain in the home during operating hours.
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Phone number on file is not Licensee's number. Per Licensee, phone number belongs to their brother which poses a potential 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.
Betty Bell
NAME OF LICENSING PROGRAM MANAGER:
Jeanine Lipsey
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 09/19/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/19/2025


LIC809 (FAS) - (06/04)
Page: 4 of 5
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: 09/19/2025
NARRATIVE
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Exit interview conducted and report was reviewed with Staff Saily Gonzales Ruano. A notice of site visit was given and must remain posted for 30 days.
NAME OF LICENSING PROGRAM MANAGER: Betty Bell
NAME OF LICENSING PROGRAM ANALYST: Jeanine Lipsey
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 09/19/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/19/2025
LIC809 (FAS) - (06/04)
Page: 5 of 5