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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 153910434
Report Date: 06/21/2021
Date Signed: 06/21/2021 02:32:18 PM

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:ALCHALATI, WALAA FAMILY CHILD CAREFACILITY NUMBER:
153910434
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 7DATE:
06/21/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:40 PM
MET WITH:Walaa AlchalatiTIME COMPLETED:
02:45 PM
NARRATIVE
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On 6/21/21 Licensing Program Analyst, (LPA) Caroline Harris conducted an unannounced annual inspection. LPA met with Licensee, Walaa Alchalati. Also present was her in-laws, Saousan Alchamaa and Mohamad Kandar who visiting but were not fingerprint cleared. LPA conducted a tour of the home, inside and outside, as shown on the facility sketches (LIC 999A) provided. The LPA observed all required licensing forms to be posted in a visible location for authorized representatives to view them. A census was taken and there were seven day care children present. The licensee stated they have one small cat. The licensee is aware of the safety of children around animals and takes responsibility for any action taken by her pets. The LPA observed inaccessible rooms to be off limits to children by the use of door knob spinners and baby gates. The accessible rooms were the two front day care rooms, the living room and hall bedroom and bathroom and the kitchen and back yard. The LPA observed safe toys and play equipment both indoors and outside. There were no poisons observed on the premises accessible to children. Licensee is aware that poisons are required to be locked and inaccessible to children. Cleaning compounds, medications and other hazardous items were inaccessible to children. There are no firearms or ammunition present at this facility. Fireplace is not in use during day care hours. There is a working fire extinguisher, smoke detector, carbon monoxide indicator, and adequate heating and ventilation for safety and comfort. The licensee has a complete first aid kit, including bandages, scissor, thermometer, gloves and a first aid manual. There are no stairs in the home. There is a working telephone and the above telephone number was verified. Adequate supervision is being provided during this visit. Capacity as specified on the license is being maintained. The outdoor play area in the back yard is fenced. Licensee is aware that children are to be supervised when outside an unfenced play area. There are no swimming pools or other bodies of water on the premises.
SUPERVISOR'S NAME: Alice JuarezTELEPHONE: (559) 650-7857
LICENSING EVALUATOR NAME: Caroline HarrisTELEPHONE: (559) 341-4624
LICENSING EVALUATOR SIGNATURE:

DATE: 06/21/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/21/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
Page: 1 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, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME: ALCHALATI, WALAA FAMILY CHILD CARE
FACILITY NUMBER: 153910434
VISIT DATE: 06/21/2021
NARRATIVE
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LPA reviewed three children’s files. All required licensing documents were observed in each of the children’s files, including a copy of the Family Child Care Home Notification of Parent's Rights (LIC 995A). Licensee also maintains documentation of immunizations for the children. Incidental Medical Services (IMS) policy was discussed. Incidental Medical Services (IMS) are not currently being provided. Licensee is aware that an IMS plan is required to be submitted to the licensing office if they provide any of these services.

Fire drills are conducted and documented with the date, time and how many children present, every six months. Licensee is aware that children are never to be left in parked vehicles. There are no excluded individuals present at this home. Licensee is aware that upon notice from the Department, any excluded individual must be immediately removed from the home and prevented from returning to the home or having contact with children in care. Licensee is aware that any authorized employee of the Department may enter and inspect any place providing personal care and services at any time, with or without advance notice. Pediatric CPR/First Aid are current and expire on 1/25/22. Licensee also maintains documentation of immunizations against pertussis, measles or influenza for herself. Days and hours of operation are Monday – Friday; 7:30 AM – 5:30 PM. An exit interview was conducted with the Licensee. LPA reviewed with licensee the Mandated Child Abuse Reporter Training (AB 1207), which the licensee completed on 2/19/20. It is required to be updated every two years. There are currently no infants in care. The LPA and licensee discussed the Community Care Licensing website: www.ccld.ca.gov. which provides access to Provider Information Notifications (PINS), Quarterly Updates that inform licensees of new legislation and regulations, training's, and Licensing forms and updated information. The licensee was also advised that it is her responsibility to stay current with regulations.

Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, the following deficiencies are found (see next page): 809 D "Upon receipt, licensee shall post and provide copies of this licensing report to parents/guardians of children in care at the facility and to parents/guardians of children newly enrolled at the facility during the next 12 months." A copy of the Fact Sheet - Child Care Parent Notification Requirements and a copy of LIC 9224 was given to licensee.

A copy of this report, along with appeal rights was provided to the licensee and was reviewed. This report shall be made available to the public upon request. The LIC 9213 Notice Of Site Visit form is required to be posted for 30 days.
SUPERVISOR'S NAME: Alice JuarezTELEPHONE: (559) 650-7857
LICENSING EVALUATOR NAME: Caroline HarrisTELEPHONE: (559) 341-4624
LICENSING EVALUATOR SIGNATURE:

DATE: 06/21/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/21/2021
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, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: ALCHALATI, WALAA FAMILY CHILD CARE
FACILITY NUMBER: 153910434
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/21/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Request Denied
Type A
06/23/2021
Section Cited

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Criminal Record Clearance. All individuals subject to a criminal record review as specified in H&S Section 1596.871 prior to working, residing or volunteering in a licensed home, shall obtain a California clearance or a criminal record exemption.
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This requirement was not met as evidenced by the licensee having her uncleared in-laws present during day care hours. Therefore, a civil penalty is assessed ($100.00 per violation per day for a maximum of five days by the Department).
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Alice JuarezTELEPHONE: (559) 650-7857
LICENSING EVALUATOR NAME: Caroline HarrisTELEPHONE: (559) 341-4624
LICENSING EVALUATOR SIGNATURE:
DATE: 06/21/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/21/2021
LIC809 (FAS) - (06/04)
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