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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376100421
Report Date: 08/13/2021
Date Signed: 08/13/2021 02:17:59 PM

Document Has Been Signed on 08/13/2021 02:17 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:NASIRI, JAMILA FAMILY CHILD CAREFACILITY NUMBER:
376100421
ADMINISTRATOR:JAMILA NASIRIFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(619) 305-6122
CITY:EL CAJONSTATE: CAZIP CODE:
92020
CAPACITY: 14TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
08/13/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:30 PM
MET WITH:Jamila NasiriTIME COMPLETED:
02:30 PM
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On 8/13/21 Licensing Program Analyst Michael Morales-DeSilvestore conducted an unannounced Annual inspection with the Licensee. Licensees daughter Laila Zolmati was present to translate to Pashto. The 2 story home was toured and inspected to ensure an environment safe for the care and supervision of children. Present were the Licensee and zero day care children. Licensee states she has not had children since 8/6/21 and they will be returning on 8/17/21. The fire extinguisher, smoke detector, and carbon monoxide detector meet requirements and are operational. All hazardous items were latched/locked and secured out of reach of children. There are no bodies of water on the property. Licensee states that there are no weapons in the home. A review of staff records on this date indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse clearances or exemptions. First Aid and CPR certifications expire on 6/20/22. Licensee has required immunizations. Licensee is exempt from mandated reporter training as their primary language is Pashto. Children’s records were reviewed and found to be in order.

Licensee has provided adequate space for the children to eat, sleep and play within the home. Areas used for child care include Family Room, Living room, dining room, downstairs bathroom and kitchen. Off limits areas include entire upstairs and are inaccessible through use of baby gates. Garage is also off limits and is kept inaccessible through the use of door knob cover and lock. The licensee has sufficient toys and equipment available. The home uses a nearby park for outdoor activity.
SUPERVISORS NAME: Tashima Daniel
LICENSING EVALUATOR NAME: Michael Morales-DeSilvestore
LICENSING EVALUATOR SIGNATURE: DATE: 08/13/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/13/2021
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: NASIRI, JAMILA FAMILY CHILD CARE
FACILITY NUMBER: 376100421
VISIT DATE: 08/13/2021
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Provider is hereby reminded of the following: Report suspected child abuse and neglect, maintain children’s records according to regulation, post all required forms, ensure that all adults living or working in the home have criminal background clearances to avoid civil penalties associated with this requirement; corporal punishment, smoking, exersaucers, bouncy seats, walkers, and jumpers are not allowed in day care. All equipment that is used should be used only as intended by the manufacturer. Licensee was also provided with information regarding Safe Sleep Regulations/SIDS and Shaken Baby Syndrome. LPA and Licensee discussed California Megan's Law and LPA provided: www.meganslaw.ca.gov.

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 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.

The licensee was provided a copy of their appeal rights (LIC 9058 12/15) and their signature on this form acknowledges receipt of these rights.

LPA provided notice of site visit and observed it being posted at the facility.
SUPERVISORS NAME: Tashima Daniel
LICENSING EVALUATOR NAME: Michael Morales-DeSilvestore
LICENSING EVALUATOR SIGNATURE:

DATE: 08/13/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/13/2021
LIC809 (FAS) - (06/04)
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