<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376101665
Report Date: 10/11/2023
Date Signed: 10/11/2023 01:42:35 PM

Document Has Been Signed on 10/11/2023 01:42 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 NORTH, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME:SARFERAZ, MARRY FAMILY CHILD CAREFACILITY NUMBER:
376101665
ADMINISTRATOR:MARRY SARFERAZFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(619) 653-7843
CITY:LAKESIDESTATE: CAZIP CODE:
92040
CAPACITY: 14TOTAL ENROLLED CHILDREN: 0CENSUS: 14DATE:
10/11/2023
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
11:35 AM
MET WITH:Marry SarferazTIME COMPLETED:
01:55 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
On October 11, 2023, at 11:35 AM, Licensing Program Analyst (LPA) Sherlynn Banas conducted an announced Pre-Licensing/ Change of Location Inspection and Increase in Capacity for Marry Sarferaz (Licensee). Upon arrival, LPA met with Applicant and 3 daughters (oldest is 22, 12, and 1 infant who is 11 months), and 1 son. The son who is 20 is fingerprint cleared. All children who are 18 and older were fingerprint cleared. The oldest daughter, Khatira Sarferaz translates for Marry Sarferaz. The two story house was toured and inspected to ensure an environment safe for the children in care at the facility. There are no bodies of water in the home. Applicant states that there are no weapons in the home. Applicant states that they have sufficient financial resources to sustain the license. CPR and First Aid expires on June 12, 2025. Preventative Health practices course was completed on January 22, 2019, which includes lead poison prevention training. Mandated reporter training expires on August 8, 2025. Immunization requirements were met. Required documents have been posted. Applicant owns the home. The applicant has toys available.

Applicant will be using the following rooms for childcare: Living room, bathroom 1, and bedroom 3 are used as accessible for day care. Off-limits areas include bedroom # 1, 2, and the bathroom inside backyard are inaccessible using doorknob covers. The second story is inaccessible. There is a gate installed to go upstairs. LPA asked if there is a separate room or place for isolation when one child/ children were sick, and she stated bedroom 3 will be used. Garage is off limits. Applicant stated that she will take the children for outdoor activities at Lindo Lake County Parkand understands that visual supervision is always required. Verification of control of property is on file. Property owner/Landlord notification is on file. Landlord consent is on file for 14 children. Child Care Home License (LIC279) must be submitted with a change of capacity fee of $25.
SUPERVISORS NAME: Tashima Daniel
LICENSING EVALUATOR NAME: Sherlynn Banas
LICENSING EVALUATOR SIGNATURE: DATE: 10/11/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/11/2023
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
SAN DIEGO NORTH, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME: SARFERAZ, MARRY FAMILY CHILD CARE
FACILITY NUMBER: 376101665
VISIT DATE: 10/11/2023
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
26
27
28
29
30
31
32
Applicant was reminded that all adults 18 and over living in the home, persons who provide care and supervision to clearance or exemption must 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 to $500.00 maximum per day/per person will be assessed if this regulation is violated.

LPA reviewed with applicant the LIC 311D, Forms/Records to Keep in Your Family Child Care Homes, children’s forms/records, facility forms/records, and information to be posted. The new provider packet was reviewed with the applicant including information on child abuse and unusual incident reporting. LPA provided information regarding 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 applicant discussed Shaken Baby Syndrome and California Megan's Law. LPA provided: www.meganslaw.ca.gov.


LPA discussed the safe sleep regulations with applicant and discussed the Child Care Licensing Safe Sleep information which can be found at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed applicant 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.
SUPERVISORS NAME: Tashima Daniel
LICENSING EVALUATOR NAME: Sherlynn Banas
LICENSING EVALUATOR SIGNATURE:

DATE: 10/11/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/11/2023
LIC809 (FAS) - (06/04)
Page: 2 of 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN DIEGO NORTH, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME: SARFERAZ, MARRY FAMILY CHILD CARE
FACILITY NUMBER: 376101665
VISIT DATE: 10/11/2023
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
26
27
28
29
30
31
32
Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platform. To receive important licensed related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

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.



There were corrections such as:

1. Cover the fireplace are needed.
2. Cover some outlets at the hallway, room 3, bathroom and the outlet by the stairs.
3. Cover for heater.

A license for 14 children may be granted upon final file review. Applicant agreed to comply with all regulations and laws governing family child-care homes.

Exit interview conducted and report was reviewed with the applicant Marry Sarferaz and Khatira Sarferaz (translator) and Appeal Rights was provided.
SUPERVISORS NAME: Tashima Daniel
LICENSING EVALUATOR NAME: Sherlynn Banas
LICENSING EVALUATOR SIGNATURE:

DATE: 10/11/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/11/2023
LIC809 (FAS) - (06/04)
Page: 3 of 3