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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191611025
Report Date: 08/10/2022
Date Signed: 08/10/2022 03:56:37 PM

Document Has Been Signed on 08/10/2022 03:56 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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:ESMAIL, P. T. FAMILY DAY CAREFACILITY NUMBER:
191611025
ADMINISTRATOR:ESMAIL, PARVIZFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(310) 452-0322
CITY:SANTA MONICASTATE: CAZIP CODE:
90405
CAPACITY: 12TOTAL ENROLLED CHILDREN: 12CENSUS: 0DATE:
08/10/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
02:02 PM
MET WITH:Parviz EsmailTIME COMPLETED:
04:00 PM
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Licensing Program Analyst (LPA) Doris Whitmore conducted a unannounced visit for the purpose of an unannounced inspection.. LPA met with licensee, Parvis Esmail, who guided analyst on a tour of the facility. Upon arrival, LPA Whitmore observed that there were no children in care or teachers. At the time of the inspection it was only licensee husband present. Licensee shared with the LPA that she is currently closed and have no children in Care. Licensee shared that she has been closed since March 2020. LPA shared with the Licensee about inactive status and a form to fill out. LPA shared with the Licensee that if she wants to open back up to communicate with the Office..

This is a single story 3 bedroom, 2 bathroom home and was inspected as follows: living room, bedroom bathrooms dining room, kitchen and outdoor play deck. The following are the off limit areas: the master bedroom, bathroom and kitchen. Licensee shared with LPA that at the time the facility was caring for the children Child care was provided in the front two bedrooms for napping as well as the living room and family nook area for napping. LPA observed a shaded deck for the children to play. Outdoor play of children was conducted in the back yard which is well fenced and equipped with outdoor toys that are age appropriate and in good repair. The kitchen area was inspected for safety and was off limits to children in care.
LPA observed a working smoke detector, carbon monoxide detector, fully charged 2A10BC fire extinguisher and a working telephone. There was good lighting and ventilation at the facility as well. All electrical outlets were covered with plastic covers. All detergents, cleaning supplies are stored in well latched cabinets. Sharp objects, including knives are stored in well latched cabinets in the kitchen. Per the licensee, there are no firearms on the premises. LPA observed a first aid kit, age appropriate toys which were in plastic containers on the deck.
SUPERVISORS NAME: Claudia Escobedo
LICENSING EVALUATOR NAME: Doris Whitmore
LICENSING EVALUATOR SIGNATURE: DATE: 08/10/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/10/2022
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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: ESMAIL, P. T. FAMILY DAY CARE
FACILITY NUMBER: 191611025
VISIT DATE: 08/10/2022
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At the time of the inspection LPA was unable to review the following documentation posted on the board Facility license, Notification of Parents Rights, Earthquake Preparedness, Licensee shared with LPA that she was unaware that the forms should still be posted and no children in care. LPA shared with the licensee and provided a copy of the Entrance Checklist. LPA discussed in detail the forms to be posted , required documentation in the children's files and staff files LPA also shared with the Licensee about the CARETool and How to access it? LPA discussed with the licensee the importance of keeping her Mandated Reporter training current & First Aid.

LPA discussed with licensee that walkers, exersaucers/walkers without wheels, jumpers & bouncers are not allowed in day care facilities. LPA discussed capacity limitations, new car seat law, personal rights, Notification of Parent's Rights revised 12/06, inspection authority & agency's consultative role. Smoking is prohibited on the premises when children are present. The LPA also discussed earthquake safety and necessity of drills every 6 months. The applicant was also informed that all adults living in or having access to day care children in the home are required to have fingerprint clearances with Department of Justice, FBI and Child Abuse Index prior to having contact with children. If the aforementioned is not adhered to, a Civil Penalty of $100 /day per uncleared adult will be assessed.

The following were also discussed with licensee:

Assembly Bill 633: Upon receipt by the licensee, licensees are to provide to parents/guardians the following: Copies of any licensing reports that document a Type A citation- this includes facility visits and substantiated complaint investigations; copy of licensing documents pertaining to a conference conducted by a local licensing agency management representative and the licensee of this family child care home in which issues of noncompliance are discussed or copies of a summary of an accusation indicating the Department's intent to revoke the facility's license. Copies of any of the above licensing documents the licensee has received in the prior 12 months shall be provided to parents/guardians of newly enrolled child at the facility.

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SUPERVISORS NAME: Claudia Escobedo
LICENSING EVALUATOR NAME: Doris Whitmore
LICENSING EVALUATOR SIGNATURE:

DATE: 08/10/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/10/2022
LIC809 (FAS) - (06/04)
Page: 2 of 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: ESMAIL, P. T. FAMILY DAY CARE
FACILITY NUMBER: 191611025
VISIT DATE: 08/10/2022
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Senate Bill 792: This bill, commencing September 1, 2016, prohibits a person from being employed or volunteering at a child care facility or family day care if he or she has not been immunized against influenza, pertussis and measles.
Exit interview was conduced and there are no deficiencies. Licensee was provided a copy of report and Appeal Rights.
SUPERVISORS NAME: Claudia Escobedo
LICENSING EVALUATOR NAME: Doris Whitmore
LICENSING EVALUATOR SIGNATURE:

DATE: 08/10/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/10/2022
LIC809 (FAS) - (06/04)
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