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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434401704
Report Date: 10/21/2024
Date Signed: 10/21/2024 12:45:59 PM

Document Has Been Signed on 10/21/2024 12:45 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
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME:FATHI, SETAREFACILITY NUMBER:
434401704
ADMINISTRATOR/
DIRECTOR:		FATHI, SETAREFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(650) 964-8677
CITY:LOS ALTOSSTATE: CAZIP CODE:
94024
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 11DATE:
10/21/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:45 AM
MET WITH:Setare FathiTIME VISIT/
INSPECTION COMPLETED:
01:00 PM
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On October 21, 2024, at 9:45 AM, Licensing Program Analyst (LPA) Elimika Woods met with licensee Setare Fathi for an Unannounced Annual/Random Inspection. LPA disclosed the purpose of the inspection and was granted entry into the facility by the licensee. Present during the inspection were the licensee's three (3) fingerprint cleared assistants, and 11 preschool age children. All adults subject to criminal background review have obtained criminal record clearance. The licensee stated that the facility operates from Monday to Friday 9:00 AM to 5:00 PM.

The off-limits will be made inaccessible by closed and/or locked doors and visual supervision. LPA checked the cabinets in the on limit areas which includes the two classrooms, bathroom, and any other cabinets or drawers accessible to children in care and did not observe any hazardous materials or toxins accessible to children during today’s inspection.

LPA toured the facility inside and out to conduct a Health and Safety inspection. The facility was clean and orderly, with heating and ventilation for the safety and comfort. At 11:00 AM, LPA inspected the backyard area to make sure that there are no pools, hot tubs or any other bodies of water present that violates the childcare licensing laws and there were none, during today's inspection.

The ON-LIMIT AREAS are the two rooms (which are set up as a classroom) and bathroom of the JADU.

The OFF-LIMIT AREAS are all of the rooms in the main house.


LPA tested the dual smoke and carbon monoxide detectors in both classrooms and found them to be functioning properly. The facility has multiple fully charged 3A40BC fire extinguishers which meets standards established by the State Fire Marshal, pull down fire alarm system, a working telephone, and first aid kits in the classrooms. The Isolation area of the facility will be a section of the front desk area, away from other children in care.

See 809-C for continuance.
SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Elimika Woods
LICENSING EVALUATOR SIGNATURE: DATE: 10/21/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/21/2024
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 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: FATHI, SETARE
FACILITY NUMBER: 434401704
VISIT DATE: 10/21/2024
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At 10:00 AM, LPA requested and reviewed the files of three (3) children in care and two (2) staff files. All children’s files contain Immunization, Identification & Emergency Information, Parent's Rights, and Medical Consent forms and the staff files have the required Employee Rights and Health Screening forms. The licensee conducts and documents fire and disaster drills twice a year with the last one conducted on 09/13/2024. The licensee's Health and Safety training is completed, and CPR and First Aid certificate is current and expires on 09/2025. The licensee has completed mandated reporter training on 08/27/2023. During the record review LPA Woods checked the Health Records of the licensee, staff, and children and found that the licensee is following the immunization laws which pertain to all childcare providers.

LPA asked the licensee does she transports children and the licensee stated that she does not transport children. Per licensee there are no weapons of any kind in the home. All required forms are posted and visible for public review.

LPA inspected the back and front yard play areas to make sure it was safe and secure for children to play at 11:00 AM. The back and front-yard was fully fenced with no opening or missing boards on the gates. The back and front yard areas are free from defects or dangerous conditions. The yards have plenty of trees and canopies for shade while children are at play. The backyard area has a swing set that’s anchored to the ground with cushioning underneath to absorb children falls. There are ample age-appropriate toys that appear to be safe and in good condition. LPA inspected the swimming pool and the gate which was at least 5 foot tall located to the far left of the yard, away from where the children play and is fully fenced to meet compliance.

Effective August 1, 2003, California Law requires Family Child Care Home licensees to report unusual incidents or injuries to children in care to child's parents and to the Department of Social Services using the Unusual Incident/Injury form (LIC 624B). Incidents must be reported within 24 hours by phone, fax, or electronic mail. LPA informed the licensee that all forms can be downloaded at www.ccld.ca.gov and encouraged the licensee to email childcareadvocatesprogram@dss.ca.gov to be included in the Child Care Quarterly Updates distribution list. The licensee was also reminded that Mandated Reporter Training ("General" and "Child Care Providers") is required for all staff and is to be renewed every 2 years by visiting www.mandatedreporterca.com.

See 809-C

SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Elimika Woods
LICENSING EVALUATOR SIGNATURE:

DATE: 10/21/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/21/2024
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
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: FATHI, SETARE
FACILITY NUMBER: 434401704
VISIT DATE: 10/21/2024
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This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see PIN 22-02-CCP. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514- 0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-carecenters/.

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. 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.

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.

The licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain childcare by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California.

During the exit interview, the LICENSEE Setare Fathi, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

There are no deficiencies cited today. A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the licensee Setare Fathi.

SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Elimika Woods
LICENSING EVALUATOR SIGNATURE:

DATE: 10/21/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/21/2024
LIC809 (FAS) - (06/04)
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