198020553-6-16-2020-33-CC-CRES-BQMTKD-20200616144745

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198020553
Report Date: 06/16/2020
Date Signed: 06/16/2020 02:54:08 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME:	SHOKRY & IBRAHIM FAMILY CHILD CARE		FACILITY NUMBER:	198020553
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY:	8	CENSUS: 6	DATE:	06/16/2020
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME BEGAN:	09:45 AM
MET WITH:	Awny Ibrahim & Mariam Shokry		TIME COMPLETED:	12:00 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	This is an Increase in capacity Tela- Face Time Inspection (via visual phone application) conducted in English today by Cynthia Reyes, Licensing Program Analyst (LPA), due to COVID-19 and precautionary measures. Met with licensee Awny Ibrahim & Mariam Shokry who guided analyst on a Face Time (via visual phone application) tour of the home inside and out. All areas identified on the facility sketch were inspected. This is a single story home. Family members residing at the facility are 2 adults and 2 children. The home was inspected for safety, comfort, cleanness, telephone service, heating and ventilation, inaccessibility to poisons, detergents, cleaning compounds, medicines, and hazardous items that can pose a danger to children. Operating hours will be Monday to Friday 6:30am to 6:00pm. Parents enter through the front door to the home. For the Large Family Child Care Home the Fire Clearance was granted on 05/27/2020. At 11:00 am, beginning the tour through the interior of the home starting at the front entrance into the living room and dinning room which is used by children and also where the parent board is located LPA observed the board to have all the required documents posted and visible for parents to see. Licensee also has a binder with all other documents needed and required for the day care. LPA also observed in those areas all the electrical outlets were covered and no hazards or poisons. In a closet in the dinning area LPA observed napping equipment (mats). Licensee states she cleans the napping mats and blankets daily. The tour proceeded though a baby gate leading from the living room into the day care room which LPA observed toys, learning materials, soft floor covering, no exposed outlets and also located in the day care room is where the licensee tested the dual carbon monoxide and smoke detectors and they were heard and observed (Face time) by LPA to be in operable condition. LPA observed a baby gate blocking off the kitchen that is off limits and the required fire extinguisher (2A 10BC) was observed (Face time) and the receipt attached to the extinguisher showed purchased date of 01/08/2020 and located in the kitchen. Next LPA observed a sliding glass door that leads to the back yard from the day care room. Continue on page 2

SUPERVISOR'S NAME: Valarie Cook	TELEPHONE: (323) 981-3362
LICENSING EVALUATOR NAME: Cynthia Reyes	TELEPHONE: (323) 981-3369
LICENSING EVALUATOR SIGNATURE:	DATE: 06/16/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/16/2020

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, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: SHOKRY & IBRAHIM FAMILY CHILD CARE	FACILITY NUMBER: 198020553
	VISIT DATE: 06/16/2020

NARRATIVE

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Per visual observation (Face time) of the back yard, it is adequately fenced (brick wall) and there is no
*swimming pool, spa or other bodies of water observed on the premises. LPA also observed playing outside 6 children, 5 in care and 1 being the licensee own child with licensee husband. LPA observed (Face time) age appropriate toys and soft grass for cushion and trees for shade.

The tour resumed inside where licensee lead LPA face time to the children bathroom located off from the dinning area next to the kitchen that has another opening however is blocked by a door that was closed to prevent access. The bathroom was free from poisons, medicine and sharp items. Per licensee there are no weapons or firearms on the premises.

The Licensee's Mariam & Awny have completed the Pediatric CPR/First Aid and expires on 11/03/2020. The certificates for Preventative Health practices were taken on: 10/27/2018 for both.

Areas used by children include: Living Room, Dinning Room, Day Care Room, Bath Room and Back Yard. (All areas Observed "Face Time" to meet Title 22 & Health and Safety Regulations on this date)

Areas off limits include: Front Yard, Kitchen, 2 Bedrooms, plus Master Bedroom with Bath & Garage.
**Rooms that are off-limits need to be made inaccessible during operating hours. The Licensee does understand that licensing staff may have access to off-limit areas during inspection if necessary **

Licensee has been advised of the following

·Children and Staff records must be maintained and updated and must be available for review. (Records must be maintain for 3 years after a child or staff leave the facility)
·Fire and Earthquake drills must be performed every six months and documented for review by the Department. (It is recommended to be conducted and documented each month by your LPA)
Posting Requirements are to be posted in an area visible for the parent & the Department to see.
Individuals who are 18 years of age or older living or frequently visiting the home must be finger print cleared prior to being in the day care home.
100% Outdoor supervision is always required. If outdoor area is not adequately fenced, provider must always be with children when outdoors

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SUPERVISOR'S NAME: Valarie Cook	TELEPHONE: (323) 981-3362
LICENSING EVALUATOR NAME: Cynthia Reyes	TELEPHONE: (323) 981-3369
LICENSING EVALUATOR SIGNATURE:	DATE: 06/16/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/16/2020

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, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: SHOKRY & IBRAHIM FAMILY CHILD CARE	FACILITY NUMBER: 198020553
	VISIT DATE: 06/16/2020

NARRATIVE

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Continued from page 2

Changes should be reported to the Department as soon as they occur such as construction, remodeling, telephone number changes and/or if you move from your home.
Any unusual incidents or injuries must be reported to the Department within 24 hours via telephone and within seven (7) days in writing. (Use LIC 624B for written report).
LPA advised the applicant how to access forms, regulations and quarterly updates on the Child Care Licensing Website at: www.ccld.ca.gov .
LPA advised the licensee to sleep infants where the infant can be directly supervised and advised against sleeping infants in a separate room. LPA reviewed SIDs, Never Shake A Baby, and safe sleeping practices. Infants should sleep mouth up, on their backs, free of clutter surrounding their sleeping space. Safe sleep concepts were provided.

LPA asked the licensee’s practices related to COVID-19. Licensee stated that she practices hygiene such as hand washing with the children. Licensee has hand sanitizer available by the drop off area inside the front door of her home, which was observed by the LPA with face time. Licensee states she practices social distancing with children and with napping and will have some children sleep separated in the day care and living room.

Exit interview was conducted with Licensee, Including, but not limited to Provider Rights, Appeal Procedures and Agencies Consultative Role. Based on this information and LPA's observation, the licensee is in compliance with California Title 22 Regulations. Therefore, there are no citations being issued or corrections needed on this date. The licensee Is approved for a Large family child care license.

Note: A copy of this report was signed by LPA Reyes. This report along with the appeal rights will be sent via email to Awny Ibrahim & Mariam Shokry who agrees to sign and date each page of the report, and understands that an electronic “Read Receipt” is in lieu of a signature at this time and/or confirmation of receipt of the e-mail confirms receipt of the report and constitutes an electronic signature. Applicant/Licensee also agrees to send the original report by mail. As this is a Face Time Tele-Inspection.

SUPERVISOR'S NAME: Valarie Cook	TELEPHONE: (323) 981-3362
LICENSING EVALUATOR NAME: Cynthia Reyes	TELEPHONE: (323) 981-3369
LICENSING EVALUATOR SIGNATURE:	DATE: 06/16/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/16/2020

LIC809 (FAS) - (06/04)

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