376100360-8-17-2023-51-CC-JLOT-CUT22F-20230817170037

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 376100360
Report Date: 08/17/2023
Date Signed: 08/17/2023 05:00:45 PM

Document Has Been Signed on 08/17/2023 05:00 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
CCLD Regional Office, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108

FACILITY NAME:	DIZAYI, ROZHAN FAMILY CHILD CARE		FACILITY NUMBER:	376100360
ADMINISTRATOR:	ROZHAN DIZAYI		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(619) 808-7480
CITY:	SANTEE	STATE: CA	ZIP CODE:	92071
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 8	CENSUS: 8	DATE:	08/17/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	12:40 PM
MET WITH:	Licensee, Rozhan Dizayi		TIME COMPLETED:	02:45 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	Licensing Program Analyst (LPA), Jennifer Lott conducted an unannounced Annual Licensing Inspection. LPA was greeted at the front door by Licensee, Rozhan Dizayi and granted entry after identifying herself and disclosing the purpose of her visit. The licensee is using the following areas for daycare: Kitchen, dining room, living room, play room, hallway bathroom, 1 child bedroom, back yard playground. Off limit areas include: Garage, 3 bedrooms, master bathroom, front yard and side yards. The facility currently has 9 children in care of which 2 were infants. Licensee provided a copy of their current roster and is operating within the licensed ratio and capacity. At 1:00pm, LPA/licensee tested the carbon monoxide detector, smoke detector and fire extinguisher located in the kitchen/hallway area. All devices were functional. There are no pools/bodies of water on the premises. There are no weapons or ammunition stored in the home. Fireplaces is screened to prevent access by children. There are no stairs in the home. Storage for poisons, detergents, cleaning solutions, medications are locked and inaccessible to children. Outdoor play area is fenced and free of hazards. The last disaster/fire drill was conducted on 04/25/2023. The home is kept clean and orderly with heating and ventilation for safety and comfort. The home provides safe toys, play equipment and materials. Children’s records contained emergency contact information. All parents or representatives received a copy of the Family Child Care Home Notification of Parent’s Rights. Pediatric CPR and First Aid cards are current and will expire on 03/2024. Staff immunizations were reviewed and are in compliance. There is a working telephone and email address.

SUPERVISORS NAME: Tashima Daniel
LICENSING EVALUATOR NAME: Jennifer Lott
LICENSING EVALUATOR SIGNATURE:	DATE: 08/17/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/17/2023

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
CCLD Regional Office, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108

FACILITY NAME: DIZAYI, ROZHAN FAMILY CHILD CARE	FACILITY NUMBER: 376100360
	VISIT DATE: 08/17/2023

NARRATIVE

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Safe Sleep
LPA discussed the safe sleep regulations with Licensee, Dizayi 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, Dizayi 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.

Criminal Record Clearance
Licensee, Dizayi was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in health and Safety code section 1596.871, must obtain 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

No IMS
Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. When any IMS is provided, a Plan for Providing IMS must be submitted 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.

SUPERVISORS NAME: Tashima Daniel
LICENSING EVALUATOR NAME: Jennifer Lott
LICENSING EVALUATOR SIGNATURE:	DATE: 08/17/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/17/2023

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, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108

FACILITY NAME: DIZAYI, ROZHAN FAMILY CHILD CARE	FACILITY NUMBER: 376100360
	VISIT DATE: 08/17/2023

NARRATIVE

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MyChildCarePlan.org
Licensee, Dizayi was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

To improve the quality and value of the new inspection process, a survey may 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/inspection-process.

Based on today’s visit, deficiencies were observed and noted on the attached LIC 809D. Exit interview conducted and report was reviewed with Licensee, Dizayi. During the exit interview, the Licensee, Dizayi confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS. A notice of site visit was given and must remain posted for 30 days.

SUPERVISORS NAME: Tashima Daniel
LICENSING EVALUATOR NAME: Jennifer Lott
LICENSING EVALUATOR SIGNATURE:	DATE: 08/17/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/17/2023

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 08/17/2023 05:00 PM - It Cannot Be Edited

Created By: Jennifer Lott On 08/17/2023 at 02:05 PM

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
, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108

FACILITY NAME: DIZAYI, ROZHAN FAMILY CHILD CARE	FACILITY NUMBER: 376100360
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 08/17/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

102418(g)

Immunizations

(g) The licensee shall document each child's immunizations as required by the California Code of Regulations, Title 17, Section 6070, and shall maintain such documentation for as long as the child is enrolled. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on LPA's record review, the licensee did not comply with the section cited above for 1:5 children care were missing immunization records which pose a potential health & safety risk to persons in care.
	POC Due Date: 08/31/2023
	Plan of Correction
1 2 3 4	Licensee states that they will collect the current immunization record from the 1:5 children in care and submit a copy to LPA via fax or email by POC date.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

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:

Tashima Daniel

LICENSING EVALUATOR NAME:

Jennifer Lott

LICENSING EVALUATOR SIGNATURE:

DATE: 08/17/2023

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/17/2023

LIC809 (FAS) - (06/04)

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