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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343626156
Report Date: 09/23/2024
Date Signed: 09/23/2024 10:47:07 AM

Document Has Been Signed on 09/23/2024 10:47 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
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:FAIZI, SHAFIQAFACILITY NUMBER:
343626156
ADMINISTRATOR/
DIRECTOR:		FAIZI, SHAFIQAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(916) 671-6680
CITY:SACRAMENTOSTATE: CAZIP CODE:
95835
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 0DATE:
09/23/2024
TYPE OF VISIT:PrelicensingANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:30 AM
MET WITH:Shafiqa FaiziTIME VISIT/
INSPECTION COMPLETED:
11:00 AM
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On Monday, 23 September 2024 at approximately 9:30am, Licensing Program Analyst (LPA) Fabian Schwartz met with Licensee Shafiqa Faizi, for the purpose of a pre-licensing inspection for a change of location and capacity increase. Also present was applicant's husband Farhad Faizi and Mariyam Mohmandi who was present as a translator. Applicant’s primary language is Pashto. All individuals subject to criminal background review have obtained a criminal record clearance.

During inspection, LPA could not see evidence of Licensee living in home. Licensee informs LPA that they will not start living in home until later this week. LPA informs licensee that they can not be granted a license until the home is ready for childcare to start operating and that licensee is living in the home. LPA observed the facility to be in the process of being moved into with empty bedrooms and missing furniture.

A health and safety inspection was conducted inside and out. This facility is a two-story home. The home has a living room, kitchen, five bedrooms, three bathrooms, two garages, and a backyard. Off-limit areas: ENTIRE UPSTAIRS, KITCHEN, AND GARAGEs. Off-limits areas will remain inaccessible to children by gates and/or supervision. Toxic and hazardous items are inaccessible to children and are stored in upstairs laundry room. A functioning smoke detector, carbon monoxide detector, and a 2A-10-BC fire extinguisher were observed in the home.

Due to Licensee not currently living in the home, facility is not approved for a large family child care home license. LPA will return during a separate visit and must observe evidence of residency as well as an adequate set up for childcare including toys and areas appropriate for child care activities.

SUPERVISORS NAME: Amanda Blesi
LICENSING EVALUATOR NAME: Fabian Schwartz
LICENSING EVALUATOR SIGNATURE: DATE: 09/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/23/2024
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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