434417446-12-16-2024-07-CC-MSMS-DBZPNM-20241216102809

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434417446
Report Date: 12/16/2024
Date Signed: 12/16/2024 10:28:25 AM

Document Has Been Signed on 12/16/2024 10:28 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
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME:	ALAMDARHA, MARZIEH		FACILITY NUMBER:	434417446
ADMINISTRATOR/ DIRECTOR:	MARZIEH ALAMDARHA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(669) 233-3404
CITY:	SAN JOSE	STATE: CA	ZIP CODE:	95131
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 0	CENSUS: 0	DATE:	12/16/2024
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	08:30 AM
MET WITH:	Marzieh Alamdarha		TIME VISIT/ INSPECTION COMPLETED:	10:30 AM

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	Licensing Program Analyst (LPA) Mel Matos met with Marzieh Alamdarha, Applicant, to conduct an announced prelicensing inspection. Applicant has applied for a large Family Child Care Home license and proof of experience is on file. LPA was granted access to the home by the Applicant. No other adult(s) or child(ren) were present in the home during today's inspection. No children were present during today's inspection. Applicant and Applicant's brother (Mohammad Alamdarha) are the adults residing in the home. There are no minor children residing in the home. Days and hours of operation will be Monday - Friday from 7 AM to 6 PM. Applicant completed her Preventative Health and Safety Training on 11/10/2024 and a copy of the certification is on file. Applicant's CPR and First Aid certifications are current and expire on 08/29/2026. Applicant completed the Mandated Reporter Training for Child Care Workers on 06/17/2023 and a copy of the certification is on file. A copy of current TB test, Mmr, Tdap, and flu vaccinations for the Applicant are on file. Because the Applicant rents/leases the home, proof of landlord notification is required. LPA observed the Property Owner/Landlord Notification form (LIC 9151) that the Applicant confirms was provided to the property owner/landlord. Applicant obtained a signed Property Owner/Landlord Consent form (LIC 9149). Copies of both documents are on file. Applicant provided proof of control of property to the Department prior to today’s inspection and a copy of the lease agreement is on file. Applicant states that she will obtain liability insurance for her day care once she obtains her large Family Child Care Home License. LPA toured the indoor and outdoor areas of the home with the Applicant during today's inspection. The home is one story and there are no stairs inside the home. There are no fireplace or wall heater units inside the home. Off limit areas inside the home: Master bedroom, master bathroom, one bedroom, two locked kitchen cabinets doors, and attached garage. Off limit areas outside the home: front yard. The home is clean, orderly, including central heating/air conditioning, and ventilation, for safety & comfort. Applicant has a valid phone in the home (#669-233-3404). There is sufficient toys, supplies, and equipment for the day care children indoors. Applicant understands that she must be present in the home at least 80% of the operating hours of the day care on a daily basis and ensure that the children are supervised at all times. Applicant understands her capacity options and she understands that she cannot have more than 14 children in the home at any time with at least two qualified adults present.

SUPERVISORS NAME: Belinda Devall
LICENSING EVALUATOR NAME: Melvin S Matos
LICENSING EVALUATOR SIGNATURE:	DATE: 12/16/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/16/2024

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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: ALAMDARHA, MARZIEH	FACILITY NUMBER: 434417446
	VISIT DATE: 12/16/2024

NARRATIVE

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LPA observed a fully charged fire extinguisher (2A10BC), working combo smoke & carbon monoxide detectors, no bodies of water, and fenced backyard. Applicant states that she does not have any weapons/ammunition or pets in the home. Applicant states that she will provide all meals, including breakfast, snacks, and lunch to the day care children. Applicant understands that any food or drink brought from home shall be labeled with each child's name and properly stored.

Cleaning Products, toxic agents, medications, and sharp objects were inaccessible to children. Applicant states that any poisons will be kept in the off limits attached garage. LPA reminded Applicant that smoking, baby walkers, and similar items are not allowed in Family Child Care Homes. Applicant states that a child will be isolated in the living room area if necessary due to illness or communicable disease. Applicant has a First Aid kit with a touchless thermometer in the home. Applicant states that she will not transport children via vehicle and that she understands that children cannot be left in parked vehicles unattended at any time.

Forms of discipline to be used by Applicant: talking to children. Applicant understands that children's personal rights should not be violated; including no corporal punishment. isolation of sick children, supervision of children, capacity options, transportation of children, requirements for reporting suspected child abuse, unusual incidents/injuries, heat related illnesses, and requirements for assistant/substitute were also discussed. LPA informed the Applicant that fire/disaster drills must be practiced at least once every 6 months and documented.

Applicant states that she will not administer any medication to the children at this time. 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) or (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.

Marzieh Alamdarha, Applicant, was reminded that all adults 18 and over living in the home, persons who provide care and supervision to children, and staff who have contact with children, 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. Applicant is awaiting clearances for her adult brother who resides in the 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.

SUPERVISORS NAME: Belinda Devall
LICENSING EVALUATOR NAME: Melvin S Matos
LICENSING EVALUATOR SIGNATURE:	DATE: 12/16/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/16/2024

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
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: ALAMDARHA, MARZIEH	FACILITY NUMBER: 434417446
	VISIT DATE: 12/16/2024

NARRATIVE

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LPA reviewed with Marzieh Alamdarha, 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. Prelicensing Entrance Checklist – Family Child Care Homes (LIC 9280) was provided to the Applicant. Applicant has not received a fire clearance approval from the San Jose Fire Department as of today's inspection.

LPA discussed the safe sleep regulations with Marzieh Alamdarha, Applicant, 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 Marzieh Alamdarha, 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.

On this date, 10/30/2024, the California Attorney General - Megan’s Law website was searched for information on sex offenders required to register with local law enforcement under California's Megan's Law. No registered sex offenders were found at the facility addresses. Under state law, some registered sex offenders are not subject to public disclosure; therefore, they may not have been included in this search. However, the Department conducts a monthly cross reference of each address on record for all registered sex offenders against all CCLD facility addresses pursuant to information shared by California DOJ.

Applicant was informed of the MyChildCarePlan.org site, 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.

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 platforms. To receive important licensed related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-carelicensing/subscribe and select the Child Care option to receive email communication.

Exit interview conducted and report was reviewed with the Applicant, Marzieh Alamdarha, and advised her that a large Family Child Care Home License will be approved upon completion of the following:

1) Criminal Record & Child Abuse Index clearances for Applicant's adult brother.
2) Fire clearance approval received from the San Jose Fire Department.

SUPERVISORS NAME: Belinda Devall
LICENSING EVALUATOR NAME: Melvin S Matos
LICENSING EVALUATOR SIGNATURE:	DATE: 12/16/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/16/2024

LIC809 (FAS) - (06/04)

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