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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197493189
Report Date: 11/01/2023
Date Signed: 11/02/2023 11:53:01 AM

Document Has Been Signed on 11/02/2023 11:53 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 RO, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:KAMRAN & NADIR FAMILY CHILD CAREFACILITY NUMBER:
197493189
ADMINISTRATOR:KAMRAN & NADIRFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(310) 977-4973
CITY:TORRANCESTATE: CAZIP CODE:
90501
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 11DATE:
11/01/2023
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME BEGAN:
12:30 PM
MET WITH:Saina KamranTIME COMPLETED:
04:15 PM
NARRATIVE
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On 11/01/2023 Licensing Program Analys (LPA) Cristina Castellanos and Judy Laureano conducted an unannounced Annual Required Inspection at the above-mentioned facility. LPAs were greeted by Licensee S. Kamran. Present during today’s inspection was licensee S. Kamran.

The hours of operation are Monday through Friday 8:00am to 5:00pm. LPAs toured the home inside and outside. Currently the facility is available to take children from 8 months to 4 years old. Facility is licensed for a Large Family Child Care license with a max capacity of 14 children. Licensee is not available for overnight care. Currently living in the home is licensee, husband and two adult children.

This is a single-family home with 5 bedrooms, 3 bathrooms, 2 living rooms, a kitchen/dining room and attached garage. Families enter the home through the main entrance and kitchen/dining room is used as a walkway to the 2nd living room. Licensee confirmed child care is conducted primarily on the right side of the home: 2nd living room and bedrooms 4 and 5. Per licensee bedroom 4 and 5 are used for napping. The back porch is used for eating. The primary bathroom the children use is adjacent to the 2nd living room.

Licensee confirmed the following areas as OFF LIMITS: bedrooms 1, 2, 3 and 2 bathrooms on the left side of the home. LPAs reminded licensees that any area designated as OFF LIMITS should be made inaccessible during the hours of operation and/or while children are present.

There are no firearms or ammunition on the premises. Detergents and cleaning compounds are kept in the garage. LPAs observed a screened/barricaded fireplace in the main living room. Licensee confirmed that home is not available to take in a child that might need medication. Currently there are no children that required medication.

LPAs observed licensee test the carbon monoxide and smoke detector in the home. LPAs observed a working fire extinguisher in the dining room. LPAs reminded licensee to maintain proof of an annual service for the fire extinguisher. Licensee confirmed that home provides meals. LPA discussed the importance of maintaining a system where allergies and food restrictions are noted.

SUPERVISORS NAME: Claudia Escobedo
LICENSING EVALUATOR NAME: Cristina Castellanos
LICENSING EVALUATOR SIGNATURE: DATE: 11/01/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/01/2023
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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Document Has Been Signed on 11/02/2023 11:53 AM - It Cannot Be Edited


Created By: Cristina Castellanos On 11/01/2023 at 01:58 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: KAMRAN & NADIR FAMILY CHILD CARE
FACILITY NUMBER: 197493189

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/01/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
102416.5(d)
Staffing Ratio and Capacity
(d) For a Large Family Child Care Home, the maximum number of children for whom care may be provided at any one time when there is an assistant provider in the home, including children under age 10 who reside at the licensee's home and the assistant provider's children under age 10, shall be either:

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation and interview, the licensee did not comply with the section cited above in not having an assistant present when there were 11 children in care, which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 11/15/2023
Plan of Correction
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Licensee agrees to make sure an assistant is always present when more than 8 children are in care.
Licensee agrees to review the following video and submit a summary statement of the video to LPA:
https://ccld.childcarevideos.org/family-child-care-providers/how-many-children-can-attend-a-family-child-care-home/
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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.
SUPERVISOR'S NAME:Claudia Escobedo
LICENSING EVALUATOR NAME:Cristina Castellanos
LICENSING EVALUATOR SIGNATURE:
DATE: 11/01/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/01/2023


LIC809 (FAS) - (06/04)
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Document Has Been Signed on 11/02/2023 11:53 AM - It Cannot Be Edited


Created By: Cristina Castellanos On 11/01/2023 at 01:58 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: KAMRAN & NADIR FAMILY CHILD CARE
FACILITY NUMBER: 197493189

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/01/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1596.8662(c)
Administration of Child Day Care Licensing
(c) Current proof of completion for each licensed child day care provider or applicant for that license, administrator, and employee of a licensed child day care facility shall be submitted to the department upon inspection of the child day care or upon request by the department.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above in 2 out of 2 files missing Mandated Reporter Training which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 11/15/2023
Plan of Correction
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Licensee agrees to complete Mandated Reporter Training by set date for herself and assistant.
www.mandatedreporterca.com
Type B
Section Cited
CCR
102416.1(d)
Personnel Records
(d) All personnel records shall be maintained at the child care home and shall be available to the licensing agency for review.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above in 2 out of 2 personnel files which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 11/15/2023
Plan of Correction
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Licensee will create personnel files with all necessary LIC forms and send proof of correction via email to LPA.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Claudia Escobedo
LICENSING EVALUATOR NAME:Cristina Castellanos
LICENSING EVALUATOR SIGNATURE:
DATE: 11/01/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/01/2023


LIC809 (FAS) - (06/04)
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Document Has Been Signed on 11/02/2023 11:53 AM - It Cannot Be Edited


Created By: Cristina Castellanos On 11/01/2023 at 01:58 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: KAMRAN & NADIR FAMILY CHILD CARE
FACILITY NUMBER: 197493189

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/01/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1597.622(a)(1)
General Provisions and Definitions
(1) Commencing September 1, 2016, a person shall not be employed or volunteer at a family day care home if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above in 1 out of 2 files, assistant did not have proof of immunization which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 11/15/2023
Plan of Correction
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Licensee agrees to foward immunization to LPA by set date.
Type B
Section Cited
CCR
102418(g)
Immunizations
(g) The licensee shall document each child's immunizations as required by the California Code of Regulations, Title 17, Section 6070, and shall maintain such documentation for as long as the child is enrolled.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above in 3 out of 7 children files did not have proof of immunization, which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 11/15/2023
Plan of Correction
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Licensee agrees to foward immunization to LPA by set date.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Claudia Escobedo
LICENSING EVALUATOR NAME:Cristina Castellanos
LICENSING EVALUATOR SIGNATURE:
DATE: 11/01/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/01/2023


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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 RO, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: KAMRAN & NADIR FAMILY CHILD CARE
FACILITY NUMBER: 197493189
VISIT DATE: 11/01/2023
NARRATIVE
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Adequate heating and ventilation for safety and comfort were observed in the space. Safe toys and play equipment were observed. The home has a working telephone service and LPAs confirmed the phone number 310-977-4973.

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. Prohibited items in Family Child Care Home flyer was provided.

Capacity as specified on the license is not being maintained during today’s inspection. Assistant was not present for approximately 30 minutes; licensee is being cited a Type A citation.

Safe Sleep regulations were discussed due to program being available for infant care. 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. Infants up to 12 months of age are placed on their backs for sleeping. Individual Infant Sleeping Plan was discussed and LIC form was reviewed.

Licensee’s Mandated Reporter Training was not available for review. Pediatric CPR/Pediatric First Aid was taken 10/7/2023 by licensee and assistant. LPAs reminded licensee the importance of making sure all vendors providing Pediatric CPR and Pediatric First Aid need to be EMSA approved. LPAs reviewed 7 children’s files and observed files to be incomplete. LPA provided licensees with a current copy of the LIC 311D and LIC126 to use as a reference when auditing files. A sample packet was provided to licensee.

To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

SUPERVISORS NAME: Claudia Escobedo
LICENSING EVALUATOR NAME: Cristina Castellanos
LICENSING EVALUATOR SIGNATURE:

DATE: 11/01/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/01/2023
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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 RO, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: KAMRAN & NADIR FAMILY CHILD CARE
FACILITY NUMBER: 197493189
VISIT DATE: 11/01/2023
NARRATIVE
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Family Child Care Homes Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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.

LPAs discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep as an additional resource. LPA also informed licensee of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: https://www.ada.gov/resources/child-care-centers/.

Licensee, S. Kamran, was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with S. Kamran.

SUPERVISORS NAME: Claudia Escobedo
LICENSING EVALUATOR NAME: Cristina Castellanos
LICENSING EVALUATOR SIGNATURE:

DATE: 11/01/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/01/2023
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