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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343625109
Report Date: 06/18/2024
Date Signed: 06/18/2024 03:38:12 PM

Document Has Been Signed on 06/18/2024 03:38 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:ANDAR, HAJERAFACILITY NUMBER:
343625109
ADMINISTRATOR/
DIRECTOR:
FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 7CENSUS: 1DATE:
06/18/2024
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:40 PM
MET WITH:Hajera AndarTIME VISIT/
INSPECTION COMPLETED:
03:00 PM
NARRATIVE
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On Tuesday, June 18, 2024 at 1:40 PM, Licensing Program Analyst (LPA) Tanya Washington met with Licensee Hajera Andar for an unannounced case management inspection to increase capacity to the maximum number of 12 children. During today's inspection there were no daycare children present. Licensee's two minor children and adult son were present in the home. Licensee's sons translated during the inspection from English to Dari. Facility hours and days of operation are Monday- Sunday from 7 AM to 10 PM.

Licensee rents the facility and has informed the property landlord that she is increasing capacity to the maximum number of 14 children, however she has not received proof of signed form LIC9149 from the landlord. Licensee understands that prior to accepting 13th and 14th child, she must obtain signed landlord consent form LIC9149 and submit an application (LIC279) with a fee of $25.00 to increase to the maximum number of 14 children. LPAs discussed and provided a visual of capacity/ ratio options with and without an assistant. LPA also reminded Licensee that when her or an assistant are left alone with children they divert to small license ratio/ capacity requirements.

On June 12, 2024, Sacramento Metropolitan Fire Department granted a fire clearance to operate a large license.

The off limit areas in the home consist of: entire second floor and laundry room. The Licensee acknowledged that children may never enter these off-limit areas. Off-limit areas will remain inaccessible to children by closed door and/or supervision. Toxic and hazardous items are inaccessible to children.

Per Licensee there are no weapons on the premises. Infant safe sleep guidelines were discussed.

Licensee's CPR and First Aid is valid until 07/2024.

EFFECTIVE TODAY, 06/18/2024 THE FACILITY IS LICENSED TO SERVE A MAX. CAP OF 12 children (WHEN THERE IS AN ASSISTANT PRESENT): WITH NO MORE THAN 4 INFANTS. Notice of site visit posted and appeal rights were provided.
SUPERVISORS NAME: Amanda Blesi
LICENSING EVALUATOR NAME: Tanya Washington
LICENSING EVALUATOR SIGNATURE: DATE: 06/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/18/2024
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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