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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343623977
Report Date: 08/15/2023
Date Signed: 08/15/2023 02:26:02 PM

Document Has Been Signed on 08/15/2023 02:26 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
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:ENTEZARI, SAEEDAFACILITY NUMBER:
343623977
ADMINISTRATOR:SAEEDA ENTEZARIFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(510) 426-2748
CITY:ANTELOPESTATE: CAZIP CODE:
95843
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 0DATE:
08/15/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:55 PM
MET WITH:Saeeda Entezari, Licensee.TIME COMPLETED:
02:30 PM
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On August 15, 2023, an unannounced annual/random inspection was made today by LPA Barragan. Present at time of inspection were licensee, 0 day care children. LPA Barragan spoke with Saeeda Entezari, Licensee.

LPA tour of the home was conducted the inspection, inside and outside, as shown on the facility sketch is conducted. Licensee states there are no weapons or firearms in the home. There was no spas or pools in the home. LPA's observed poisons, cleaning compound's, medications and other hazardous items are inaccessible to children. There was a fireplace in the home, but it is inaccessible to the children. Fire extinguisher, Carbon Monoxide Detector and Smoke Detector meets regulations. Currently, Licensee does not have any pets.There are stairs in the home; however, there was a toddler gate to restrict access to the upstairs. Toys and play equipment that were observed appeared to be safe. There is a working telephone. Adequate supervision is being provided during this inspection. Children are supervised when outside in any unfenced play area. There was 0 infant under 12 months old present.

The home is a two story home with a front yard, 4 bedrooms, 3 bathrooms, kitchen, living room, dining room, garage/laundry room, and a fenced backyard. The off-limit areas are: all upstairs and garage/laundry room. Licensee was notified that prior to any changes of an on-limit to an off-limit area, or vice versa, the department must be notified.

Pediatric CPR/FA is current with expiration date of 08/2024. A child roster is maintained. Fire and disaster drills have been conducted every six months and documented. No child's records were reviewed during this inspection due to no children in care being present.
SUPERVISORS NAME: Amanda Blesi
LICENSING EVALUATOR NAME: Eduardo Barragan
LICENSING EVALUATOR SIGNATURE: DATE: 08/15/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/15/2023
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: ENTEZARI, SAEEDA
FACILITY NUMBER: 343623977
VISIT DATE: 08/15/2023
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LPA's discussed AB 633, Parent Notification Requirements, and the posting of licensing inspection notices and reports. Hours of operation are 8 AM to 8 PM; Monday thru Friday and other hours as arranged. Licensee states she does transport children.

Saeeda Entezari, Licensee, was reminded that all adults 18 and over living or working in the home, including employees and volunteers, 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 up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

LPA discussed the safe sleep regulations with Saeeda Entezari, Licensee 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. LPA also informed Saeeda Entezari, 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.


LPA observed proof that licensee and staff/ volunteers have met the requirements of SB 792.

LPA observed that all staff has completed the required mandated reporter training (AB 1207) at website: www.mandatedreporterca.com .Last completed 09/24/2022.


Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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: http://www.ada.gov/childqanda.htm .No children currently on medication.
SUPERVISORS NAME: Amanda Blesi
LICENSING EVALUATOR NAME: Eduardo Barragan
LICENSING EVALUATOR SIGNATURE:

DATE: 08/15/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/15/2023
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
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: ENTEZARI, SAEEDA
FACILITY NUMBER: 343623977
VISIT DATE: 08/15/2023
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LPA provided the Community Care Licensing website www.ccld.ca.gov, so the licensee can obtain updated licensing information, new regulations and access forms. LPA advised licensee of their responsibility to stay current in regard to new regulations. LPA also included the email address for the children's advocacy program to stay current on new laws childcareadvocatesprogram@dss.ca.gov.

To receive important licensed- related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

To improve the quality and value of the new inspection process, a survey will 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 tools, please send them by email 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/process.

No citations were administered during this inspection.

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

Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted. A copy of this report and appeal rights were reviewed/provided with Saeeda Entezari, Licensee.

SUPERVISORS NAME: Amanda Blesi
LICENSING EVALUATOR NAME: Eduardo Barragan
LICENSING EVALUATOR SIGNATURE:

DATE: 08/15/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/15/2023
LIC809 (FAS) - (06/04)
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