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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376102242
Report Date: 02/21/2025
Date Signed: 02/21/2025 12:21:29 PM

Document Has Been Signed on 02/21/2025 12:21 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:LUTFI, FROZAN FAMILY CHILD CAREFACILITY NUMBER:
376102242
ADMINISTRATOR/
DIRECTOR:		FROZAN LUTFIFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(619) 357-2614
CITY:EL CAJONSTATE: CAZIP CODE:
92021
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 2DATE:
02/21/2025
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:35 AM
MET WITH:Lutfi Frozan TIME VISIT/
INSPECTION COMPLETED:
12:45 PM
NARRATIVE
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On 2/21/25 at 10:35 am Licensing Program Analyst's (LPAs) Annette Sutherland & JC Valdez conducted case management inspection. Licensee did not have a complete roster LIC 9040. Children currently enrolled do not have files. Infant enrolled does not have LIC 9227 or Infant safe sleep log, licensee confirmed that infant was napping upstairs. The few children that do have files do not have parent signatures or complete files.

See LIC 809D for B deficiencies.



A notice of site visit was given and must remain posted for 30 days. Licensee Rights (LIC 9098 ) along with a copy of this report was provided to Licensees Frozan Lutfi. Exit interview conducted and report was reviewed with the licensee Frozan Lutfi .
SUPERVISORS NAME: Joelle Redding
LICENSING EVALUATOR NAME: Annette Sutherland
LICENSING EVALUATOR SIGNATURE: DATE: 02/21/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/21/2025
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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Document Has Been Signed on 02/21/2025 12:21 PM - It Cannot Be Edited


Created By: Annette Sutherland On 02/21/2025 at 11:11 AM
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: LUTFI, FROZAN FAMILY CHILD CARE
FACILITY NUMBER: 376102242

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/21/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/28/2025
Section Cited
CCR
102425(j)(2)

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102425(j)(2) The provider shall supervise infants while they are sleeping and adhere to the following requirements: The provider shall check and document the following:
This requirement is not met as evidenced by:
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Licensee will provide a sample safe sleep log for current infant in care by 2/28/25 via email Annette.Sutherland@dss.ca.gov.
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Based on interview and record review, the licensee did not comply with the section cited above , licensee stated she was not checking or logging sleep checks which poses/posed a potential health, safety or personal rights risk to persons in care.
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Type B
02/28/2025
Section Cited
CCR102425(j)(6)

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102425(j)(6)The provider shall supervise infants while they are sleeping and adhere to the following requirements: The provider shall be on the same floor as the sleeping infant. This requirement is not met as evidenced by::
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Licensee will submit a statement stating that she understands the safe sleep regulation and will be on the same floor as a sleeping infant.
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Based on Interview, the licensee did not comply with the section cited above in. Licensee stated that infant sleeps upstairs while she watches the children downstairs which poses/posed a potential health, safety or personal rights risk to persons in care.
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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:Joelle Redding
LICENSING EVALUATOR NAME:Annette Sutherland
LICENSING EVALUATOR SIGNATURE:
DATE: 02/21/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/21/2025


LIC809 (FAS) - (06/04)
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Document Has Been Signed on 02/21/2025 12:21 PM - It Cannot Be Edited


Created By: Annette Sutherland On 02/21/2025 at 11:16 AM
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: LUTFI, FROZAN FAMILY CHILD CARE
FACILITY NUMBER: 376102242

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/21/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/28/2025
Section Cited
CCR
102418(g)

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(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:
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LIicenesee shall provde proof of immunizations for children currently enrolled that do not attend cchol . LIcensee will submit proof via email to Annette.Sutherland @dss.ca.gov.
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Based on record review, the licensee did not comply with the section cited above. Licensee did not have immunizations for 3/4 file reviewed for children not in school i. which poses/posed a potential health, safety or personal rights risk to persons in care.
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Type B
02/28/2025
Section Cited
CCR102419(d)

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(d) At the time of acceptance of each child into care, the licensee shall provide the child's parent or authorized representative with a copy of the notice Family Child Care Home Notification of Parent's Rights, LIC 995A (8/06), the Caregiver Background Check Process, LIC 995E (6/05), and the Family child Care Consumer Awareness Information, LIC 9212 (10/05).

This requirement is not met as evidenced by:
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Licensee will write a statement stating that she understands she must have parents complete all paperwork prior to admitting children in day care and send to LPA via email Annette.Sutherland@dss.ca.gov
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Based on record review and interview the licensee did not comply with the section cited above. LIcensee had 11/19 children files avaivlbe for review which poses/posed a potential health, safety or personal rights risk to persons in care.
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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:Joelle Redding
LICENSING EVALUATOR NAME:Annette Sutherland
LICENSING EVALUATOR SIGNATURE:
DATE: 02/21/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/21/2025


LIC809 (FAS) - (06/04)
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Document Has Been Signed on 02/21/2025 12:21 PM - It Cannot Be Edited


Created By: Annette Sutherland On 02/21/2025 at 11:19 AM
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: LUTFI, FROZAN FAMILY CHILD CARE
FACILITY NUMBER: 376102242

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/21/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/28/2025
Section Cited
CCR
102417(g)(8)

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(8) Each family child care home shall have a current roster of children as specified in Health and Safety Code Section 1596.841.

This requirement is not met as evidenced by:
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Correction has been made. Licensee has provided complete roster to LPA.
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Based on interview and observation the licensee did not comply with the section cited above. LIcensee did not have a complete roster which poses/posed a potential health, safety or personal rights risk to persons in care.
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Type B
02/28/2025
Section Cited
CCR102425(c)

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An Individual Infant Sleeping Plan [LIC 9227 (3/20)] shall be completed for each infant up to 12 months of age the provider has in care and included in the infant's file at the facility.

This requirement is not met as evidenced by:
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Licensee will send proof to LPA that she has all infant forms completed. Licensee will send proof to LPA via email to Annette.sutherland@dss.ca.gov
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Based on record review, the licensee did not comply with the section cited above, Licensee did not have an infant file for infant currently enrolled which poses/posed a potential health, safety or personal rights risk to persons in care.
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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:Joelle Redding
LICENSING EVALUATOR NAME:Annette Sutherland
LICENSING EVALUATOR SIGNATURE:
DATE: 02/21/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/21/2025


LIC809 (FAS) - (06/04)
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