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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 274417223
Report Date: 03/04/2025
Date Signed: 03/04/2025 10:23:44 AM

Document Has Been Signed on 03/04/2025 10:23 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
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME:SHAGHASI, FARIHAFACILITY NUMBER:
274417223
ADMINISTRATOR/
DIRECTOR:		FARIHA SHAGHASIFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(916) 289-8519
CITY:SALINASSTATE: CAZIP CODE:
93908
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 0DATE:
03/04/2025
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:10 AM
MET WITH:Shaghasi, FarihaTIME VISIT/
INSPECTION COMPLETED:
10:35 AM
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On 3/4/2025, at 10:10 AM, Licensing Program Analyst (LPA) Liridon Fici-Doni arrived unannounced to conduct a case management visit to deliver amended reports dated for 2/25/2025. LPA was greeted and granted entry by Licensee, Shaghasi, Fariha and explained the purpose of the visit.

LPA obtained the original reports dated for 2/25/2025 and delivered amended reports today, dated for 3/4/2025.

No deficiencies cited during visit.

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


Exit interview conducted with Licensee, and this report reviewed and provided.

SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Liridon Fici
LICENSING EVALUATOR SIGNATURE: DATE: 03/04/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/04/2025
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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