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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376101567
Report Date: 08/23/2024
Date Signed: 08/23/2024 03:24:20 PM

Document Has Been Signed on 08/23/2024 03:24 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
SAN DIEGO N. CC RO, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME:NAYEBZADA, GULNAR FAMILY CHILD CAREFACILITY NUMBER:
376101567
ADMINISTRATOR/
DIRECTOR:		GULNAR NAYEBZADAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(619) 558-7552
CITY:LAKESIDESTATE: CAZIP CODE:
92040
CAPACITY: 14TOTAL ENROLLED CHILDREN: 9CENSUS: 2DATE:
08/23/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:55 PM
MET WITH:Gulnar NayebzadaTIME VISIT/
INSPECTION COMPLETED:
03:40 PM
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On 8/23/24 at 1:55 p.m., Licensing Program Analysts (LPA), Renita Rodriguez and Mahjoba Raofi, conducted an unannounced Annual Inspection. LPAs were greeted at the front door by licensee daughter Shukuria Nakyebzada. Gulnar Nayebzada arrived at 2:05 p.m. with 2 children in care. The two story home was toured and inspected for compliance. The children are provided a safe, healthful, and comfortable environment, furnishings, and equipment. Licensee was provided the Inspection Checklist. The required documents were posted in the hallway at the entrance of the home.

Children in care were observed in the living engaging in floor time play with toys available. Areas used for child care include living room, kitchen and bathroom on the first floor. The entire second floor of the home is off limits and inaccessible by security gate. The garage is off limits. The door located in the kitchen leads to the garage and is locked and latched making it inaccessible. The licensee has sufficient toys and equipment available. The home has a fenced backyard available for outdoor activities. Licensee understands that visual supervision is required at all times during outdoor activities.

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 there are no weapons in the home and LPA did not observe any. First Aid and CPR certifications expire on 12/17/24. Licensee has required immunizations. Licensee is not required to complete the Mandated Reporter Training. Licensee primary language is Farsi. Children’s records were reviewed and found to be in order.

LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep as an additional resource.

SUPERVISORS NAME: Renesha Askew
LICENSING EVALUATOR NAME: Renita Rodriguez
LICENSING EVALUATOR SIGNATURE: DATE: 08/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/23/2024
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 2
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN DIEGO N. CC RO, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME: NAYEBZADA, GULNAR FAMILY CHILD CARE
FACILITY NUMBER: 376101567
VISIT DATE: 08/23/2024
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LPA also informed licensee 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.

Licensee 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 a 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 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.

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: https://www.ada.gov/resources/child-care-centers/.

Licensee 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 CARE tools, please send email inquiries 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.

Exit interview conducted and report was reviewed with the licensee, Gulnar Nayebzada.

During the exit interview, the Licensee Gular Nayebzada, 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: Renesha Askew
LICENSING EVALUATOR NAME: Renita Rodriguez
LICENSING EVALUATOR SIGNATURE:

DATE: 08/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/23/2024
LIC809 (FAS) - (06/04)
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