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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197408592
Report Date: 06/28/2022
Date Signed: 06/28/2022 02:52:38 PM

Document Has Been Signed on 06/28/2022 02:52 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
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:NOORZAY FAMILY CHILD CAREFACILITY NUMBER:
197408592
ADMINISTRATOR:RAMZIA NOORZAYFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(818) 825-1363
CITY:CANOGA PARKSTATE: CAZIP CODE:
91304
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 9DATE:
06/28/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:53 PM
MET WITH:Ramzia Noorzay, LicenseeTIME COMPLETED:
03:15 PM
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On 06/28/22 Licensing Program Analyst (LPA) Silva Garibyan, conducted an unannounced Annual Required Inspection and was met by Licensee, Ramzia Noorzay. Also present was Staff #1 (S1). Days and hours of operation are Monday – Friday from 6:00 AM to 6:00 PM. LPA toured the home inside and outside and a census was taken. There were nine children present (including one infant). Current facility sketch was reviewed. LPA also observed a large dogs in the backyard area near the side walkway of the home. LPA was guided on a tour of the home inside and outside. The home is a one-story dwelling, 4 bedrooms, "Kid's playroom" area, 2 bathrooms, front yard, back yard, living room area, dining room area, kitchen, laundry room, and an attached garage. Off limit areas include 3 bedrooms and 1 bathroom, living room area, dining room area, laundry room, kitchen, and the attached garage. Licensee stated the backyard is no longer an on - limit area for the children and it is now off limits. Child - care is primarily be conducted in the "Kid's playroom" area off the living-room area. Other areas children has access to include the bathroom in the hallway, side walkway area of the home, the "Isolation Bedroom", and the front-yard. Per licensee, the residents at the facility are the licensee, her father (co-licensee), mother, and adult brother. There is no swimming pool or other bodies of water on the premises. There are no firearms or ammunition on the premises. All poisons are kept in a locked storage area. No poisons were observed during the inspection. Detergents, cleaning compounds, medication and other hazardous items are made inaccessible. Page 1 of 3
SUPERVISORS NAME: Karren Starks
LICENSING EVALUATOR NAME: Silva Garibyan
LICENSING EVALUATOR SIGNATURE: DATE: 06/28/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/28/2022
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
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: NOORZAY FAMILY CHILD CARE
FACILITY NUMBER: 197408592
VISIT DATE: 06/28/2022
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The fireplace located in the living room made inaccessible by a glass door. There is a working fire extinguisher, smoke detector, carbon monoxide detector and adequate heating and ventilation for safety and comfort. There are no stairs in this home. The home has working telephone service and LPA confirmed the phone number is (818) 999-6589.

There is currently one infant enrolled in care. LPA discussed Safe Sleep Regulations with licensee. There is one crib or play yard for each infant in care, cribs and play yards are kept free from all loose articles and objects while infants are sleeping, and there are no objects hanging above or attached to the crib or play yard. Infants are not swaddled while in care. Provider physically checks on sleeping infants every fifteen minutes and documents any signs of distress which includes but is not limited to flushed skin color, increase in body temperature, restlessness and labored breathing. Infants can be visually observed through an open door if sleeping in a separate room. Individual Infant Sleeping Plan is completed and in file for each infant up to 12 months of age. Infants up to 12 months of age are placed on their backs for sleeping.

Licensee ensures that children in care are supervised at all times and is aware children shall not be left in parked vehicles. Car seats are used for transportation purposes only and are not used for sleeping children. The outdoor play area in the backyard is fenced and there are no hazards to children present. Capacity as specified on the license is being maintained.

Licensee has a current roster of the children. An emergency fire/disaster drill has been completed and documented within the last 6 months. Licensees and assistant have completed the Mandated Reporter Training. Licensees’ pediatric CPR/First Aid expires on 03/09/23. A review of records indicates that all employees and/or volunteers have immunization records on file for influenza, pertussis and measles.

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SUPERVISORS NAME: Karren Starks
LICENSING EVALUATOR NAME: Silva Garibyan
LICENSING EVALUATOR SIGNATURE:

DATE: 06/28/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/28/2022
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
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: NOORZAY FAMILY CHILD CARE
FACILITY NUMBER: 197408592
VISIT DATE: 06/28/2022
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All adults who reside or work in the home have a criminal record clearance or exemption. There are no excluded individuals present at this home.

Incidental Medical Services (IMS) are not currently being provided. Licensee is aware that an IMS plan is required to be submitted to the licensing office if they provide any of these services. Information regarding Americans with Disability Act (ADA) can be obtained by contacting US Department of Justice toll free ADA Information line at (800) 514-0301(voice), (800) 514-0383 (TDD) and website link https://www.ada.gov/childqanda.htm.



LPA and Licensee discussed the Community Care Licensing website www.ccld.ca.gov which will provide access to Provider Information Notices (PINs), Quarterly Updates, COVID-19 Information and Resources, Mandated Reporter Training, Safe Sleep in Child Care, Lead Poisoning Facts, Forms and Regulations.

Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, the following deficiency is being cited: (see next page, 809 D) Licensee was provided a copy of appeal rights.

This report shall be made available to the public upon request. LIC 9213 Notice of Site Visit is provided and required to be posted for 30 days.

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SUPERVISORS NAME: Karren Starks
LICENSING EVALUATOR NAME: Silva Garibyan
LICENSING EVALUATOR SIGNATURE:

DATE: 06/28/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/28/2022
LIC809 (FAS) - (06/04)
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