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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376100907
Report Date: 12/01/2021
Date Signed: 12/01/2021 10:31:29 AM

Document Has Been Signed on 12/01/2021 10:31 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
CCLD Regional Office, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME:MATEEN, FARIDA FAMILY CHILD CAREFACILITY NUMBER:
376100907
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 0DATE:
12/01/2021
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
08:45 AM
MET WITH:Farida MateenTIME COMPLETED:
10:45 AM
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On 12/1/21 at 8:45AM, Licensing Program Analyst(LPA) Nancy Diaz conducted an announced Pre-Licensing inspection with the applicant, Farida Mateen. Also present today were Abdulhakim Mateen (husband) and Abdulkhaliq Aqeel (roommate). Mr. Mateen helped translate in Persian today.
This four-bedroom, four-bathroom two-story home was toured and inspected to ensure an environment safe for the care and supervision of children.

Applicant maintains smoke and carbon monoxide detectors and fire extinguisher in the home that meets regulation requirements. Both detectors were tested today and deemed to be operable. All hazardous items were latched and secured under the kitchen sink and drawers and are out of reach of children. Mrs. Mateen stated that she does not maintain any weapons or bodies of water within the premises. Applicant maintains a first aid kit 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. Control of property was provided to the department via copy of mortgage statement. First Aid and CPR will expire on October 2023 and Preventative Health Practices course was completed on November 2018. Mrs. Mateen completed the 1-hour Training course in Lead Poisoning Prevention on Sept. 29, 2021. Mandated Reporter Training was waived due to limited English proficiency of applicant. Mrs. Mateen's primary language is Persian.

The daycare children will have access to: the livng room, kitchen, dining, bathroom to the left (as you enter the house) and the fenced backyard. Off limit areas are: garage, downstair bathroom to the right (as you enter the house) and the second floor of the home - 3 bedrooms, 2 bathrooms and the laundry room.
CONTINUED
SUPERVISORS NAME: Tashima Daniel
LICENSING EVALUATOR NAME: Nancy Diaz
LICENSING EVALUATOR SIGNATURE: DATE: 12/01/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/01/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 3
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: MATEEN, FARIDA FAMILY CHILD CARE
FACILITY NUMBER: 376100907
VISIT DATE: 12/01/2021
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The new provider packet was reviewed with the applicant including information on child abuse reporting, children’s records, immunizations, adults living or working in the home, SIDS, Incidental Medical Services, and the YMCA Resource Center. Applicant was reminded that corporal punishment, smoking, walkers, exersaucers, jumpers and bouncy seats are not allowed in day care. All equipment that is used should be used only as intended by the manufacturer. LPA and Licensee discussed Shaken Baby Syndrome and California Megan's Law and LPA provided: www.meganslaw.ca.gov.

Applicant and LPA discussed COVID-19 guidelines and how to prevent spread of the virus. Applicant has posted COVID-19 posters in facility. Applicant was provided COVID-19 resources and directed to website: https://www.cdss.ca.gov/inforesources/community-care-licensing to receive important updates and information.

Any minor upon his/her 18th birthday must be fingerprinted within 30 days. Applicant has met all immunization requirements per SB792. Applicant is reminded to make anything that reads, "Keep Out of Reach of Children" inaccessible to children.

Applicant states that she will comply with all regulations and laws governing family child care homes and that she is financially secure to operate a family child care home for children. LPA reviewed this report with Applicant prior to obtaining her signature.
LPA discussed and provided applicant with the following: Child Care Advocates - email address childcareadvocatesprogram@dss.ca.gov and phone number (916) 654-1541.In addition, for common questions or questions regarding licensing requirements to contact the Child Care Licensing duty line at 619-767-2248.
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
CONTINUED
SUPERVISORS NAME: Tashima Daniel
LICENSING EVALUATOR NAME: Nancy Diaz
LICENSING EVALUATOR SIGNATURE:

DATE: 12/01/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/01/2021
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: MATEEN, FARIDA FAMILY CHILD CARE
FACILITY NUMBER: 376100907
VISIT DATE: 12/01/2021
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LPA discussed the safe sleep regulations with Mrs. Mateen 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 Mrs. Mateen 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.

Child Care Providers can now sign up for Quarterly Updates and PINS through the DSS website. Please go to www.ccld.ca.gov and click on Child Care, go under Quick Links and Quarterly updates, click on “Receive Important Updates” then enter your email address and choose which program(s) you would like to subscribe to and click “subscribe”.

No correction is needed. A license for a small family child care home is granted effective today, 12/1/2021.

The maximum capacity for a small family child care home: 4 infants only (infants mean any children under 24 months); or 6 children with no more than 3 infants; or (with landlord consent) 8 children with no more than 2 infants, 1 child in kindergarten or elementary school and 1 child at least age 6 including children under age 10 who live in the licensee's home.


An exit interview was conducted with Mrs. Mateen. A copy of the Appeal Rights was provided along with a copy of the prelicensing inspection report (LIC809).
SUPERVISORS NAME: Tashima Daniel
LICENSING EVALUATOR NAME: Nancy Diaz
LICENSING EVALUATOR SIGNATURE:

DATE: 12/01/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/01/2021
LIC809 (FAS) - (06/04)
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