304314100-4-9-2024-06-CC-MMAK-D46UBH-20240409152622

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 304314100
Report Date: 04/09/2024
Date Signed: 04/09/2024 03:26:33 PM

Document Has Been Signed on 04/09/2024 03:26 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
ORANGE CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME:	PIRASTEHFAR, AREZOO		FACILITY NUMBER:	304314100
ADMINISTRATOR/ DIRECTOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 8	CENSUS: 2	DATE:	04/09/2024
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	01:15 PM
MET WITH:	Licensee, Arezoo Pirastehfar		TIME VISIT/ INSPECTION COMPLETED:	04:00 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	Page 1 of 3 Licensing Program Analyst (LPA) Mahnaz (Nancy) Malek conducted a case management inspection of this facility for the purpose of increasing the capacity to Large Family Child Care home. LPA met with licensee Arezoo Pirastehfar who provided a tour of the home. LPA also met with the licensee's adult son, Arshia Fereidooni. Per the licensee, there are 4 adults and no minors living in the home. LPA took census. There were 2 napping children of whom all were under 24 months old. The log for every 15 minutes check on infants were reviewed and the facility was in compliance. A review of the Facility Personnel Report Summary indicates on 4/9/2024 the adult resident received caregiver background check clearances or exemptions as required by the Department. The licensee's operation hours are Monday through Friday, 7:30 AM- 5:30 PM. Care and supervision will be provided to children ages one month to 12 years old. For the purposes of licensing, an infant is defined as any child from 0 to 24 months of age. All areas identified on the facility sketch were inspected, including but not limited to, off limit areas. Off limits areas are made inaccessible by means of baby gates. The childcare area consists of family room, dinning area, living room, one bedroom, children's bathroom, and back yard. The kitchen area and living room/dinning room area are separated by baby gates. Children's bathroom is next to the bedroom in the hallway. A gate has separated the hallway from children's area. No hazardous items were observed in the children's bathroom. One bedroom is for napping children equipped with 4 pack and play and mats. Main childcare room is accessed upon entering the home from the entrance of the home. Garage is locked and inaccessible to children. There is a dog living in the house with Cavapoo Breed. There is a small height swing with cushioning materials underneath it. There are no bodies of water on the premises. The licensee does have a current Continued on page 2

SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Mahnaz Malek
LICENSING EVALUATOR SIGNATURE:	DATE: 04/09/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/09/2024

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
ORANGE CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: PIRASTEHFAR, AREZOO	FACILITY NUMBER: 304314100
	VISIT DATE: 04/09/2024

NARRATIVE

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roster of children in care. Fire Drill log was reviewed and the last one was conducted on 2/14/2024. Children’s records for children present during LPA’s inspection were reviewed for a copy of the emergency information card that contains all the information specified by regulation (LIC 700) and found to be in compliance. LIC 9227 for children under 12 months old were on file. The log for every 15 minutes check on napping children under 24 months old reviewed. (Total of 2 files were reviewed). The licensee's Pediatric CPR/First Aid certification card is current expiring 9/2024.
Areas that will be used by children were inspected for safety, comfort, cleanliness, telephone service (cell phone), ventilation and heating.
Detergents, cleaning compounds, medicines, sharp objects, and hazardous items that can pose a danger to children are inaccessible in areas designated for children. The licensee stated that there are no poisons on the premises and LPA did not observe any. The licensee was advised that any poisons must be locked with a key or combination lock. Per licensee, there were no weapons or firearms on the premises.
Smoke and carbon monoxide detectors were working. The pressure gauge on the 2A-10BC fire extinguisher indicates fully charged, as indicated on the service tag observed (mounted on the wall in the kitchen). Fire clearance has been approved and received in our office.
The Child Advocacy Program was discussed with the licensee. The licensee was advised to register for the program to receive quarterly reports and other information in a timely manner. To register email ChildCareAdvocatesProgram@dss.ca.gov.
The LPA advised the applicant on how to access forms, regulations, and quarterly updates on the Child Care Licensing website at: www.cdss.ca.gov/inforesources/community-care-licensing. LPA reviewed and issued the LIC311D “Forms/Records to Keep in Your Family Child Care Home” and provided to licensee.
Children's files were reviewed and they were all in compliance.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. When any IMS is provided, an updated Plan of Operation that includes 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) or (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm Incidental Medical Services (IMS) - Family Child Care Homes.
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SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Mahnaz Malek
LICENSING EVALUATOR SIGNATURE:	DATE: 04/09/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/09/2024

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
ORANGE CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: PIRASTEHFAR, AREZOO	FACILITY NUMBER: 304314100
	VISIT DATE: 04/09/2024

NARRATIVE

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The licensee, Arezoo Pirastehfar was reminded that all adults 18 and over living in the home, persons who provide care and supervision to children, and staff who have contact with children, 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.

LPA discussed the safe sleep regulations with the applicant 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 an additional resource. LPAs also informed the 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.

Licensee, Arezoo Pirastehfar was informed of the MyChildCarePlan.org site, 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.

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platforms. The licensee has been signed up for this.

The Small Family Child Care Home was in compliance with Title 22 Regulations at the time of inspection. The request for Large Family Child Care Home will be discussed with the management in the office. In the event additional requirements are needed, the licensee will be notified.

A notice of site visit was given to licensee, Arezoo Pirastehfar and must remain posted on, or immediately adjacent to the interior side of the main door for 30 days. Failure to post will result in Civil Penalties of $100.00. Appeal rights were provided. Exit interview conducted and report was reviewed with the licensee, Arezoo Pirastehfar.

End of report

SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Mahnaz Malek
LICENSING EVALUATOR SIGNATURE:	DATE: 04/09/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/09/2024

LIC809 (FAS) - (06/04)

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