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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197406880
Report Date: 11/14/2024
Date Signed: 11/14/2024 05:00:47 PM

Document Has Been Signed on 11/14/2024 05:00 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:ZOLFAGHARI FAMILY CHILD CAREFACILITY NUMBER:
197406880
ADMINISTRATOR/
DIRECTOR:		ZOLFAGHARI MARYAMFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(818) 341-6830
CITY:CHATSWORTHSTATE: CAZIP CODE:
91311
CAPACITY: 14TOTAL ENROLLED CHILDREN: 10CENSUS: 6DATE:
11/14/2024
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
03:00 PM
MET WITH:Maryam Zolfaghari, LicenseeTIME VISIT/
INSPECTION COMPLETED:
05:15 PM
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Licensing Program Analysts (LPA) Elicia Calvillo conducted an unannounced annual required inspection to the above facility on 11/14/2024. LPA arrived at the facility at 03:00 PM, identified self and met with Maryam Zolfaghari, Licensee, who guided analyst on a tour of the inside and outside of the facility. There were 6 children present at arrival. LPA provided Licensee with a copy of the LIC125 Entrance Checklist to help facilitate the inspection. Facility operation hours are Monday to Friday from 6:00 AM to 6:00 PM.

The family child care home is a one-story dueling with a living room, kitchen, den with kitchenette, 4 bedrooms, and 3 bathrooms. There is a fenced front drive way used to drop off and pick up children. There is a fenced outdoor play area in the back of the house. LPA observed there is no property fence and Licensee confirmed they are the property owner for 10549 DeSoto Avenue, Chatsworth, CA 91311 and 10547 DeSoto Avenue, Chatsworth, CA 91311.

LPA observed the following inside areas will be used for child care: den with kitchenette, and bathroom #1 are used for providing care and are accessible to children. The den with kitchenette is used for learning activities, arts and crafts, play activities, eating and sleeping. LPA observed cots, bed linens stored in the closet, tables and chairs, and toys and play items that are safe, clean, and appropriate for the ages of the children.

LPA did observe a pool and bird bath or similar bodies of water during the inspection. LPA observed the pool fences is not not in good repair, children could remove portions of the fence, is not at least five feet high, is easily climbable by children, self latching device is not more that six inches from the top of the gate, and the opening between railing is more that 4 inches (see photos).

LPA observed that the children's files are not complete.

SUPERVISORS NAME: Rita Ramos
LICENSING EVALUATOR NAME: Elicia Calvillo
LICENSING EVALUATOR SIGNATURE: DATE: 11/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/14/2024
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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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: ZOLFAGHARI FAMILY CHILD CARE
FACILITY NUMBER: 197406880
VISIT DATE: 11/14/2024
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LPA observed Licensee Maryam Zolfaghari, Tooradj Zolfaghari, and Staff #1 personnal records are not complete.

Due to time restraint, LPA is unable to complete the Annual Inspection and will return at a later date to complete an Annual Continuation Visit and complete citations for the deficiencies observed.

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 Maryam Zolfaghari, Licensee including, but not limited to Provider Rights, Appeal Procedures and Agencies Consultative Role.
SUPERVISORS NAME: Rita Ramos
LICENSING EVALUATOR NAME: Elicia Calvillo
LICENSING EVALUATOR SIGNATURE:

DATE: 11/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/14/2024
LIC809 (FAS) - (06/04)
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