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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304312043
Report Date: 11/03/2025
Date Signed: 11/03/2025 10:29:11 AM

Document Has Been Signed on 11/03/2025 10:29 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
ORANGE CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME:RASTA, MAHJANFACILITY NUMBER:
304312043
ADMINISTRATOR/
DIRECTOR:		RATSA, MAHJANFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(949) 481-6748
CITY:SAN CLEMENTESTATE: CAZIP CODE:
92673
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 9DATE:
11/03/2025
TYPE OF VISIT:Case Management - Legal/Non-complianceUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:45 AM
MET WITH:LicenseeTIME VISIT/
INSPECTION COMPLETED:
11:00 AM
NARRATIVE
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An case management inspection was conducted at the facility by Licensing Program Analyst (LPA) Mahnaz (Nancy) Malek. At the time of inspection at 08:45 am, LPA met with licensee, Mahjan Rasta who was taking care of 9 children of whom 4 were under 24 months old, (16 months old, 18 months old, 21 months old, and 23 months old), 4 were over preschool age, and one school age child. There was no assistant present with these number of children as it is required to. Licensee was not operating within the licensed capacity as specified on license for Large Family Childcare Home. Two infants (21, and 23 months old) and school age child were picked up at 8:55 am during LPA's presence. An immediate civil penalty of $250.00 is assessed today because this is a repeat of same violation within the last 12 months. The previous violation was on 11/14/2024. A review of the Facility Personnel Report Summary on this date indicates all facility residents, staff, or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. According to licensee, currently there are two adults including the licensee, and no minors living in the house. Day care hours of operation is Monday through Friday from 7:30 am-5:00 pm. During today’s inspection, LPA toured the inside and outside areas identified in the facility sketch as accessible to childcare children. Off limits areas are made inaccessible by means of baby gates. The childcare area consists of family room/dinning room. There are two gates installed on both sides of the kitchen make it inaccessible to children. There is a baby gate installed between the children's area and hallway to make it inaccessible for children to the front entrance. There is a baby gate installed in front of the stairs to make upstairs inaccessible to children. There are two closets in the entrance way behind the baby gate. Part of back yard is for children's use. There is a small decorative fountain on the other side of the gate in the back yard above the ground in the off limit area which was non-operable and free of water. The gate Continued on page 2
NAME OF LICENSING PROGRAM MANAGER: Thuy Ho
NAME OF LICENSING PROGRAM ANALYST: Mahnaz Malek
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 11/03/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/03/2025
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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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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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
ORANGE CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME: RASTA, MAHJAN
FACILITY NUMBER: 304312043
VISIT DATE: 11/03/2025
NARRATIVE
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on the children's area in the side yard makes it inaccessible to children from going to the off limit area of back yard. There is a fire pit in the off limit area behind the baby gate which was not in operation. The side yard is covered with carpet for children's use. There are age appropriate toys and equipment for children to play outside. There are 4 cribs available for infants and sleeping bags are available for older children for napping. The garage is not for children's use and is inaccessible to children by the garage door being locked. There are working carbon monoxide, smoke detector, and fire extinguishers in the home that meet statutory and State Fire Marshall standards.
The licensee has a current roster of children in care. Fire Drill Log was current. The last fire drill was conducted 7/7/2025. Children’s records for children present during LPA’s inspection were reviewed. Seven files were reviewed. They were all in compliance. The log for every 15 minutes check on napping children under 24 months old were available. LIC 9227 (Individual Infant Sleeping Plan) for infants under 12 months old were available on their files. The licensee's Pediatric CPR/First Aid certifications are current. (Expires 3/31/2027).LPA discussed the safe sleep regulations with Licensee Mahjan Rastai and discussed the Child Care Licensing Safe Sleep webpage at: https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep, as The following deficiency was observed on today's inspection. Please refer to 809D next page.
Licensee, Mahjan Rasta was informed that the “Notice of Site Visit” must be posted for 30 consecutive days. The “Notice of Site Visit” must be posted on or adjacent to the door. Failure to post will result in Civil Penalties of $100.00. LPA Malek informed Licensee, Mahjan Rasta that this report dated 11/3/2025 documents type A citation shall be posted for 30 consecutive days as there is immediate risks to the health, safety, or personal rights of children in care. Also, LPA Malek informed the Licensee, Mahjan Rasta to provide a copy of this licensing report dated 11/3/2025 that documents any Type A citation to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report.
A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification. Licensee, Mahjan Rasta was provided with a copy of their appeal rights (LIC 9058) and their signature on this form acknowledges receipt of these rights. All appeals must be in writing and received by the Regional Office within 15 business days. The exit interview was conducted with Licensee, Mahjan Rasta. End of report
NAME OF LICENSING PROGRAM MANAGER: Thuy Ho
NAME OF LICENSING PROGRAM ANALYST: Mahnaz Malek
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 11/03/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/03/2025
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 11/03/2025 10:29 AM - It Cannot Be Edited


Created By: Mahnaz Malek On 11/03/2025 at 09:51 AM
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
, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: RASTA, MAHJAN
FACILITY NUMBER: 304312043

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/03/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
11/04/2025
Section Cited
CCR
102416.5(e)

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Staffing Ratio and Capacity- If no assistant provider is present at a Large Family Child Care Home, then the licensee shall comply with the capacity requirements for a Small Family Child Care Home as specified in subsections (b) and (c). This requirement is not met as evidenced by based on LPA's
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During LPAs' presence, two of the children who were under 24 months old and one school age child were picked up at 8:55am. Additionally, the licensee agreed to send a statement staying to comply with ratio at all times. An immediate civil penalty of $250.00 is assessed today because this is
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observation at 08:45 am that there were 4 children under 24 months, 4 preschool children and one school age present with the presence of licensee only. This is an immediate risk to the health and safety of children in care.
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a repeat of same violation within the last 12 months. The previous violation was on 11/14/2024. The proof of correction will be sent to LPA's email address by the due date of 11/4/2025.

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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.
Thuy Ho
NAME OF LICENSING PROGRAM MANAGER:
Mahnaz Malek
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 11/03/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/03/2025


LIC809 (FAS) - (06/04)
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