503911485-5-27-2021-04-CC-NLOI-C3EVLV-20210527163235

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 503911485
Report Date: 05/27/2021
Date Signed: 05/27/2021 04:33:03 PM

Document Has Been Signed on 05/27/2021 04:33 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
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME:	NAZARPOUR, VIEALET FAMILY CHILD CARE		FACILITY NUMBER:	503911485
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 0	CENSUS: 0	DATE:	05/27/2021
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	02:15 PM
MET WITH:	Vielalet Nazarpour		TIME COMPLETED:	04:45 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	Prior to today's inspection, LPA telephoned call applicant and conducted the COVID-19 Emergency Response Tele-Inspection Screening Process. On May 27, 2021, Licensing Program Analyst (LPA), Norma Lomeli met with Applicant, Viealet Nazarpour for a pre-licensing inspection. Applicant and her two minor children reside in the home. Background clearances are discussed and LIS 531 is signed indicating that the adults currently living in the home and/or providing care and supervision to children have a criminal record clearance. Facility was inspected inside and outside as shown on the facility sketch and the following items were discussed: This is a single story, three bedrooms and two bathrooms home and children will have access to the living room, dining room, kitchen, bedroom #1 (day care room), bedroom #2 (day care room) and hallway bathroom. Off-limits rooms are made inaccessible by use of plastic door knob cover or door locks. There is a fireplace in the living room that applicant states it will not be used during day-care hours. LPA observed in bedroom #1 and bedroom #2; children size furniture, building blocks and other safe toys and books for the children. LPA also observed a colorful alphabetical area rug, a high chair and a flat screen television that is located in the living room. Children will nap in bedroom #1, bedroom #2 and in the living room on mats. Infants will nap in play yards. Applicant understands she is to supervise children at all times. Facility has 3A40BC fire extinguisher, smoke alarm, carbon monoxide alarm and first aid kit in place. (Continued on LIC809-C):

SUPERVISORS NAME: Duane Matsubara
LICENSING EVALUATOR NAME: Norma Lomeli
LICENSING EVALUATOR SIGNATURE:	DATE: 05/27/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/27/2021

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
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: NAZARPOUR, VIEALET FAMILY CHILD CARE	FACILITY NUMBER: 503911485
	VISIT DATE: 05/27/2021

NARRATIVE

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Applicant’s Pediatric CPR and First Aid certification was completed through American Heart Association and expires on January 31, 2023.
Preventative Health and Safety class was completed on February 26, 2021.
Knives are stored inside a top kitchen cabinet. Medications are stored inside a top kitchen cabinet that is made inaccessible by the use of a child proof safety latch. Cleaning compounds are stored in the laundry closet inside a top cabinet.
Advised applicant fire drills are to be conducted once every 6 months and must be documented with date and time. A fire drill log was provided as an example.
Applicant is advised at least one staff member with current training in pediatric first aid and pediatric CPR is to be on site at all times children are present.
There is an in-ground pool that is fenced with rod iron fencing. The gate is self-latching/self-closing and swings away from the pool. LPA observed two windows from the home that have direct access to the in-ground pool.
There is a bird that is kept inside a cage in the office which is a room inaccessible to the day care children. Applicant is advised it is her responsibility to ensure the safety of children in care at all times from the pets.
Applicant states there are no firearms or ammunition in the home or premises. Poisons are kept locked inside a shed that is located in the backyard in an inaccessible area to the day care children.
Applicant is reminded that any advertising (of day-care) such as business cards, flyers/posters, and/or signs must include facility number as per Title 22 Regulation "Advertisements and License Number" 102359 (a).
Applicant is advised that smoking is prohibited on the premises of a family child care home as specified in Health and Safety Code Section 1596.795(a). Applicant states the home is smoke-free.
Applicant states she will be transporting day care children. Applicant understands that she must have proper restraints and/or car seats for all the children under her care when transporting children.
Fenced backyard's side run has a cemented area for the day care children to play. LPA observed a Little Tikes play house, a water table and other safe toys.
SB 792 immunizations verified and on file.

(Continued on LIC809-C):

SUPERVISORS NAME: Duane Matsubara
LICENSING EVALUATOR NAME: Norma Lomeli
LICENSING EVALUATOR SIGNATURE:	DATE: 05/27/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/27/2021

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
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: NAZARPOUR, VIEALET FAMILY CHILD CARE	FACILITY NUMBER: 503911485
	VISIT DATE: 05/27/2021

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Applicant completed the Mandated Reporter Training on March 8, 2021.
LPA discussed safe sleep pending regulations and Safe Sleep Regulation Concepts were given to applicant.
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.

Required postings, forms packet, which included Parent Notification Requirement and LIC9224 were provided and discussed in detail. Applicant is advised that she may access CCLD website at www.ccld.ca.gov for additional forms and licensing updates. She is also reminded that it is her responsibility to read the regulations periodically. Applicant states she will operate her day care Monday through Friday from 7:00 AM to 5:30 PM and as arranged. No overnight care will be provided.

LPA & applicant discussed the Community Care Licensing website: LPA and applicant discussed new additions to the website that include the new PIN (Provider Information Notification) and information for providers including the Quarterly Update that informs licensees of new legislation and regulations. Please follow these steps go to http://www.cdss.ca.gov/, click on “information and resources” click “Community Care Licensing” Click “quarterly updates” click “Child Care advocates program” and register to PIN.

Applicant is advised the following items must be corrected and documentation be sent to CCL within the next 30 days to avoid possible withdraw.

Applicant will prevent access to the in-ground pool from four windows of the home. Applicant will ensure that the barricade(s) to the in-ground pool meet Title 22 Regulations. LPA observed a rod iron fence that is not five feet high and on one end of the fence there is a stepping rod; the height from the stepping rod is not at least 46 inches high.

Pending verification of corrections of the above items and a second prelicensing inspection, licensure as a Small Family Day Care Home capacity of 8 children ages under 18 years will be recommended.

SUPERVISORS NAME: Duane Matsubara
LICENSING EVALUATOR NAME: Norma Lomeli
LICENSING EVALUATOR SIGNATURE:	DATE: 05/27/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/27/2021

LIC809 (FAS) - (06/04)

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