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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343624091
Report Date: 09/30/2022
Date Signed: 09/30/2022 08:53:43 AM

Document Has Been Signed on 09/30/2022 08:53 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:HAMIDI, ROINAFACILITY NUMBER:
343624091
ADMINISTRATOR:HAMIDI, ROINAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(916) 640-0129
CITY:MCCLELLAN PARKSTATE: CAZIP CODE:
95652
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 2DATE:
09/30/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:15 AM
MET WITH:Roina HamidiTIME COMPLETED:
09:15 AM
NARRATIVE
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On September 30, 2022 at approximately 8:15 AM, Licensing Program Analysts (LPAs) Alize Tillery and Mandie Goodwin met with licensee Roina Hamidi for the purpose of an annual required 1 year inspection. The facility’s days and hours of operation are Monday – Friday, available 24 hours. Licensee understands she may not care for one child, more than 24 hours. LPAs observed care and supervision of 2 children supervised by the Licensee and her spouse. All individuals subject to criminal background review have obtained a criminal record clearance. Licensee does not offer transportation services.

A health and safety evaluation was conducted in all areas accessible to children. There are no off limit areas in the home.

LPAs observed a 2A10BC fire extinguisher, first aid kit and functioning smoke and carbon monoxide detectors. Per licensee, there are no weapons in the home. Toxic and hazardous items are inaccessible to children, and safe toys were observed. LPA discussed current COVID19 guidelines with Licensee.

LPAs reviewed with Licensee what is to be maintained in children files. Required postings and the children’s roster was observed. Licensee has record of conducting fire drills at least every six months. Per record, last drill was conducted on 04/25/2022. Licensee and all other adult files was observed to be complete. LPA observed licensee’s CPR and First Aid card which expires 04/4/2023. Licensee is exempt from the mandated reporter training, due to language barrier. Licensee’s primary language is Dari.

LPAs reviewed and provided the Family Child Care Home Entrance Checklist.

Continued on LIC809C…
SUPERVISORS NAME: Seychelle De Luca
LICENSING EVALUATOR NAME: Alize Tillery
LICENSING EVALUATOR SIGNATURE: DATE: 09/30/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/30/2022
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
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833
FACILITY NAME: HAMIDI, ROINA
FACILITY NUMBER: 343624091
VISIT DATE: 09/30/2022
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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 submitting 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

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.

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 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 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.

During today’s inspection, no deficiencies were observed. A notice of site visit was given and must remain posted for 30 days. Exit interview was conducted and report was reviewed with the Licensee, Roina Hamidi.

SUPERVISORS NAME: Seychelle De Luca
LICENSING EVALUATOR NAME: Alize Tillery
LICENSING EVALUATOR SIGNATURE:

DATE: 09/30/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/30/2022
LIC809 (FAS) - (06/04)
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