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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343624289
Report Date: 04/16/2024
Date Signed: 04/16/2024 12:07:12 PM

Document Has Been Signed on 04/16/2024 12:07 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:FAZLI, RANA & FAZILFACILITY NUMBER:
343624289
ADMINISTRATOR/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 2DATE:
04/16/2024
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:15 AM
MET WITH:Rana FazliTIME VISIT/
INSPECTION COMPLETED:
12:15 PM
NARRATIVE
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On Tuesday, April 16, 2024, Licensing Program Analyst (LPA) Amanda Sutter met with licensees Rana and Fazil Fazli for the purpose of a Capacity Increase from 8 to 14 children. The Fire Safety Inspection Clearance has been received from the Sacramento Metro Fire Department on April 8, 2024, and the home has been cleared for up to 14 children. All individuals subject to criminal background review have obtained a criminal record clearance. Upon arrival, LPA observed licensee supervising two children.

A health and safety evaluation was conducted in all areas accessible to children. The home is two stories. Off-limit areas include: entire upstairs and garage. Licensees acknowledged that children may never enter these off-limit areas. LPA did not observe a fire drill log and licensee stated that he did not have a copy of the paperwork and requested a new form. LPA discussed fire drill requirements with licensee.

Large family child care home capacity limitations were reviewed during today's visit. Licensees acknowledges that when there is no assistant present, facility will revert back to the small capacity. Licensees acknowledges that children residing in the home under the age of 10 years shall be included in capacity.

A notice of site visit was given and must remain posted for 30 days. Based on the inspection, one Type B citation has been issued. Exit interview conducted and report was reviewed with the licensees Rana and Fazil Fazli.

Effective today, April 16, 2024, LPA will approve the capacity increase to serve up to either 14 children, two (2) of which must be at least 6 years of age and no more than three (3) may be infants; or 12 children, four (4) of which may be infants. Infants are children under the age of 2.
SUPERVISORS NAME: Seychelle De Luca
LICENSING EVALUATOR NAME: Amanda Sutter
LICENSING EVALUATOR SIGNATURE: DATE: 04/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/16/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 2
Document Has Been Signed on 04/16/2024 12:07 PM - It Cannot Be Edited


Created By: Amanda Sutter On 04/16/2024 at 11:46 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
, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: FAZLI, RANA & FAZIL
FACILITY NUMBER: 343624289

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/16/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
05/10/2024
Section Cited
CCR
102417(g)(9)(A)(1)

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102417 Operation of a Family Child Care Home (g)(9)(A) Each family child care home shall conduct fire drills...at least once every six months. 1. The licensee shall document the drills, including the date and time of each drill...
This regulation was not met as evidenced by:
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Licensee will submit proof of a conducted fire drill to LPA by date listed.
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Based on interview and record review, the licensee has not conducted a fire drill and does not have a fire drill log, which poses/posed a potential health, safety or personal rights risk to persons in care.
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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.
SUPERVISOR'S NAME:Seychelle De Luca
LICENSING EVALUATOR NAME:Amanda Sutter
LICENSING EVALUATOR SIGNATURE:
DATE: 04/16/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/16/2024


LIC809 (FAS) - (06/04)
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