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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197404233
Report Date: 06/12/2024
Date Signed: 06/12/2024 10:36:51 AM

Document Has Been Signed on 06/12/2024 10:36 AM - 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:ADEL ARJOMAND & SAFAFIAN FAMILY DAY CAREFACILITY NUMBER:
197404233
ADMINISTRATOR/
DIRECTOR:		ADEL ARJOMAND, ESTERFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(818) 776-1959
CITY:ENCINOSTATE: CAZIP CODE:
91316
CAPACITY: 14TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
06/12/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:00 AM
MET WITH:Ester Adel Arojomand, LicenseeTIME VISIT/
INSPECTION COMPLETED:
11:00 AM
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Licensing Program Analyst (LPA) Alicia Mooberry conducted an unannounced case management inspection to the above facility. LPA met with Licensee Ester Adel Arojomand. Upon arrival the licensee stated the facility is not operating and there are no children enrolled. LPA did not observe children present. The Licensee requested to place facility on inactive status from 6/12/24 to 6/12/25. The licensee completed form LIC 9211 Request for Inactive Child Care License Status during this visit.

LPA discussed the the conditions of Inactive Status as follows, the licensee agrees to comply with all of the following conditions:
a. Will not provide child care for more than one (1) family until license is reactivated.
b. Will continue to promptly pay the annual license fee.
c. Will inform your office of any changes in the above dates prior to re-opening my facility by submitting a new LIC 9211.
d. Will be in compliance with all licensing laws and regulations upon re-opening my facility, including but not limited to:
● Ensuring all adult staff and residents, including children who turn 18 during the inactive period, have criminal record clearances
● Maintaining current CPR and First Aid certifications
● Maintaining a current fire extinguisher and functioning smoke alarms

Exit Interview conducted with licensee Ester Adel Arojomand.
SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Alicia Mooberry
LICENSING EVALUATOR SIGNATURE: DATE: 06/12/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/12/2024
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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