Mujadidi, Nahid Fcch

102417(g)(3) · Operation of A Family Child Care Home (g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (3) Where children are less than five years old are in care, stairs shall be fenced or barricaded.

Deficient Practice Statement Based on observation and interview, the licensee did not comply with the section cited above as stairs were accessible to children in care which poses/posed a potential health, safety or personal rights risk to persons in care. POC Due Date: 05/29/2026

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102418(a) · Immunizations (a) Prior to admission to a family day care home, children shall be immunized against diseases as required by the California Code of Regulations, Title 17, beginning with Section 6000.

Deficient Practice Statement Based on observation, interview and record review, the licensee did not comply with the section cited above in 1 out of 5 children C3 did not have proof of immunization records which poses/posed a potential health, safety or personal rights risk to persons in care. POC Due Date: 05/29/2026

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102419(d)(1) · Admission Procedures and Authorized Representatives Rights (d) At the time of acceptance of each child into care, the licensee shall provide the child's parent or authorized representative with a copy of the notice Family Child Care Home Notification of Parent's Rights, LIC 995A (8/06), the Caregiver Background Check Process, LIC 995E (6/05), and the Family child Care Consumer Awareness Information, LIC 9212 (10/05). (1) The licensee shall request the child's parent or authorized representative to sign and date the bottom portion of the notice form LIC 995A (8/06), which acknowledges that the parent or authorized representative has received and read the LIC 995A. The bottom portion of this form must be kept in the child’s file as proof that the parent or authorized representative has been notified of his or her rights and received a copy of the Caregiver background Check Process, LIC 995E (6/05), and the Family Child Care Consumer Awareness Information, LIC 9212 (10/05).

Deficient Practice Statement Based on observation, interview and record review, the licensee did not comply with the section cited above in 2 out of 5 children, C3 & C4 files were missing LIC995A form which poses/posed a potential health, safety or personal rights risk to persons in care. POC Due Date: 05/29/2026

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102370(d) · (d) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1596.871 shall prior to working, residing or volunteering in a licensed facility

LPA reminded Licensee that all adult 18 years & older residing in the home or working is required to obtained an approved criminal record clearance. Licensee stated she would contact parents to have Based on the Licensee's statement, Obs., & Guardian review 2 of 3 staff are not fingerprint cleared or associated to facility. The licensee did not comply w/ section cited above which poses an immediate health, safety or personal rights risk to persons in care. them pick up some of the children so 1 staff would be in ratio and S1 & S2 would be asked to get fingerprinted & not return to facility premises until cleared and associated. Licensee to provide Department w/ self-certification that all adults over 18 years of age in the facility premises have been fingerprint cleared and associated to the facility by 11/18/22. SUPERVISOR'S NAME: Jordan Monath

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