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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343624382
Report Date: 06/01/2023
Date Signed: 06/01/2023 01:50:06 PM

Document Has Been Signed on 06/01/2023 01:50 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
RIVER CITY (SACTO)CC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:NAZRABI, KHALIDAFACILITY NUMBER:
343624382
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 3DATE:
06/01/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Khalida NazrabiTIME COMPLETED:
02:30 PM
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On June 1st, 2023 at 1:00 PM, Licensing Program Analyst (LPA) Mandie Goodwin met with Licensee Khalida Nazrabi, for the purpose of an unannounced required 1-year inspection. Licensee has also requested to increase from a small family childcare to a large family childcare. A fire clearance was granted 6/1/2023 for the entire downstairs, excluding the garage. There were no other adults at the time of visit. All individuals subject to criminal background review have obtained a criminal record clearance. LPA observed licensee’s own 3 children under 10 years old at time of visit. Licensee’s child provided translation along with licensee’s spouse over the phone. Facility days and hours of operation are Monday through Friday from 6:00 AM until 12:00 AM.

LPA toured the facility and a health and safety inspection was conducted in all areas accessible to children. The off-limits areas include the entire upstairs, the outside patio, and the garage. Licensee acknowledged that children must never enter these areas. LPA observed the required postings, a fully charged fire extinguisher, and smoke and carbon monoxide detectors. Per Licensee, there are no weapons in the home. No bodies of water were observed today. Toxic and hazardous items are inaccessible to children.

LPA reviewed a sample of 2 enrolled children’s files, which were observed to be complete. A current children’s roster was observed. LPA discussed that fire drills must be conducted every 6 months. LPA observed licensee’s CPR and First Aid card which expires 2/19/2024. Licensee is exempt from mandated reporter training is it is not offered in her first language of Dari. LPA reviewed and provided the Family Child Care Home Entrance Checklist.

LPA discussed CCR 102416.5 (d) which discusses the required ratios and capacity for a Large Family Child Care. LPA discussed personnel records needed for assistants. LPA discussed required documentation for adult and minor assistants. (Report continues LIC809-C)
SUPERVISORS NAME: Seychelle De Luca
LICENSING EVALUATOR NAME: Mandie Goodwin
LICENSING EVALUATOR SIGNATURE: DATE: 06/01/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/01/2023
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
RIVER CITY (SACTO)CC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: NAZRABI, KHALIDA
FACILITY NUMBER: 343624382
VISIT DATE: 06/01/2023
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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.

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


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 Khalida Nazrabi.



Effective today, June 1st 2023, Licensee’s request for a Large Family Child Care License is approved. Licensee can now provide care for 12 children (when there is an assistant present) with no more than 4 infants or capacity of 14 children when 1 child in kindergarten or elementary school and 1 child at least age 6 and a maximum of 3 infants. Infants are children under the age of two years. Licensee understands that when there is no assistant present, ratios of a small capacity must be adhered to.
SUPERVISORS NAME: Seychelle De Luca
LICENSING EVALUATOR NAME: Mandie Goodwin
LICENSING EVALUATOR SIGNATURE:

DATE: 06/01/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/01/2023
LIC809 (FAS) - (06/04)
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