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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343624066
Report Date: 12/22/2021
Date Signed: 12/29/2021 10:36:05 AM

Document Has Been Signed on 12/29/2021 10:36 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
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833
FACILITY NAME:TOKHI, SAHARFACILITY NUMBER:
343624066
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 3DATE:
12/22/2021
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
12:30 PM
MET WITH:Sahar TokhiTIME COMPLETED:
01:45 PM
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On 12/20/2021 at approximately 12:30pm Licensing Program Analysts (LPAs) Gagandeep Singh and Josiah Gathing met with Licensee, Sahar Tokhi, for a case management inspection. Licensee applied for a capacity increase from 8 to 14 children in care. Today’s inspection was conducted in order to inspect the house and discuss requirements for a large license. The purpose of the inspection was explained.

During today’s inspection, LPAs inspected the day care areas. Daycare areas are: Living room, Sunroom, Kitchen, Hallway, Bathroom in hallway, one bedroom in hallway on left side of bathroom and Backyard. Off limit areas: Entire second floor, Two bedrooms on ground floor, Garage and two storage sheds in the backyard. All off limits areas must remain inaccessible to children. Isolation of an ill child will be in the bedroom next to the bathroom. Licensee was notified that prior to the use of any off limits area, the department must be notified.

During the inspection, LPAs observed the home has multiple smoke alarms and fire extinguishers. There is a carbon monoxide detector and pull alarm. All sharp corners of the home and furniture has been covered with cushioned material. The house was inspected by local fire marshal and the clearance was granted on December 14, 2021. During the inspection LPAs informed licensee of the ratio and capacity requirements of large family home license. Licensee stated that she understands the requirements.

No violations were observed today. The application will be forwarded to Licensing Program Manager for review before approval.

Copy of this report was reviewed and provided to licensee. This report will be kept in the facility file and will be made available for public review upon request.

SUPERVISORS NAME: Seychelle De Luca
LICENSING EVALUATOR NAME: Josiah Gathing
LICENSING EVALUATOR SIGNATURE: DATE: 12/22/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/22/2021
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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