Pre-licensing visit·July 30, 2025

Licensing Program Analyst (LPA) Tatiana Bickham conducted an announced pre-licensing inspection for a large family child care at the above facility on 07/30/2025 at 9:00 AM. This is a change of location application, previous license number 195700534. LPA met with Applicant Fatemeh Nik, who guided LPA on a tour of the facility. There were no children present when LPA arrived. Per Applicant, hours of operation will be Monday through Friday, 6:30am to 5:00pm. Applicant states they will provide care for children 0 weeks to 12 years of age. This is a single story ADU connected to the applicant's previous family childcare home (6030 Manton Ave), there is a door located next to the kitchen that connects both homes. LPA informed applicant the door connecting both homes must be locked at all times during operation hours. LPA informed applicant once the new address is licensed they cannot provide care in the other home. This facility has an open floor plan and consists of a living room, kitchen, bathroom, storage shed, front yard and backyard. The home was inspected for safety, cleanliness, telephone service, heating and ventilation, inaccessibility to poisons, detergents, cleaning compounds, medicines, and hazardous items that can pose danger to children. Areas used by children include: The living room, kitchen, bathroom adjacent to the living room, and backyard. Areas off limits include: The storage shed located in the backyard and the front yard. Off limit areas are made inaccessible by door lock. There are no knives, sharp utensils, or cleaning supplies located in the home. Page 1. The home is clean and orderly, there are outlet covers throughout the home. Smoke/carbon monoxide detectors were observed, tested and found to be operable. Applicants have completed the required health and safety training, the Pediatric First Aid and CPR. Applicants have proof of immunization against pertussis and measles, and declination letters for influenza on file. Proof of Mandated Reporter Training was also provided. Applicant states they will provide food for the children. LPA reminded Applicant that food brought from home should be labeled with the child's name and properly refrigerated. LPA observed age-appropriate toys and learning materials. The required (2A10BC) fire extinguisher was observed in the bathroom and was purchased in February 2025. Per Applicant, there are no weapons or firearms in the facility. Per Applicant, the children will use the backyard for outdoor play. The outdoor play area was observed to be fenced. LPA observed that the outdoor yard has toys and other materials for children to play with. LPA did not observe any objects that could be hazardous to children in care. There are no pools or spas, or other bodies of water. The isolation area for sick children waiting to be picked up will be in the corner of the living room, away from other children. The Applicant provided proof of control of property. Applicant owns the property. 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. 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. LPA informed Applicant any unusual incidents or injuries must be reported to the Department within 24 hours via telephone and within seven (7) days in writing. Fire and safety drills must be performed every six months Page 2. and documented for review by the Department and smoking tobacco is not allowed in a home that is licensed as a family day care home, and in those areas of the family day care home where children are present. A current roster of children enrolled must be available and maintained for a period of three years, even after children no longer are attending the facility. Annual fees must be paid promptly and by the due date or a late fee shall be assessed, and/or the License shall be terminated. The fire extinguisher type 2A-10BC must be serviced annually or as often as necessary. Smoke and carbon monoxide detectors should be checked, batteries should be replaced. Changes should be reported to the Department as soon as they occur, such as construction and remodeling. Telephone number changes and/or if you move from home. LPA reviewed and provided copies to the applicant regarding LIC 311D, Forms/Records To Keep In Your Family Child Care Homes, children\342\200\231s forms/records, facility forms/records, and information to be posted. CHILDREN'S RECORDS REQUIREMENTS: \342\200\242 LIC 700 Identification and Emergency Information \342\200\242 LIC 627 Consent for Emergency Medical Treatment \342\200\242 LIC 282 Affidavit Regarding Liability Insurance \342\200\242 LIC 9150 Parent Notification Additional Children in Care \342\200\242 LIC 9927 Individual Infant Sleeping Plan \342\200\242 LIC 995A Notification of Parent\342\200\231s Rights \342\200\242 Immunization Record \342\200\242 15 minute safe sleep log Page 3. FACILITY RECORDS: \342\200\242 LIC 624B Unusual Incident/Injury Report \342\200\242 LIC 9040 Child Care Facility Roster \342\200\242 LIC 9052 Employee Rights, \342\200\242 LIC 9108 Statement Acknowledging Requirement to Report Child Abuse \342\200\242 LIC 9149 Property Owner/Landlord Consent Form \342\200\242 LIC 9151 Property Owner/Landlord Notification Form \342\200\242 Proof of current pediatric CPR and First Aid Certificates \342\200\242 Copy of your deed or lease/rental agreement \342\200\242 Documentation of Fire and Disaster drills \342\200\242 Proof of immunizations against pertussis (TDAP), measles (MMR), and influenza \342\200\242 Mandated Reporter certificate \342\200\223 www.mandatedreporterca.com \342\200\223 must be renewed every two (2) years FORMS TO BE POSTED \342\200\242 LIC203 Facility License \342\200\242 LIC 610A Emergency Disaster Plan \342\200\242 LIC 9148 Earthquake Preparedness Checklist \342\200\242 PUB394 Notification of Parents Rights Poster 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 . 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. LPA discussed the safe sleep regulations with applicant and discussed the Child Care Licensing Safe Sleep webpage at Page 4. https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep 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. On this date, 07/30/25, the California Attorney General - Megan\342\200\231s 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. 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-care-licensing/subscribe and select the Child Care option to receive email communication. LPA will submit application for approval for a large family child care with a capacity of 14. Page 5.