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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 214200067
Report Date: 07/02/2019
Date Signed: 07/02/2019 10:22:10 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME:HAWWASH, EHAB & ENASFACILITY NUMBER:
214200067
ADMINISTRATOR:HAWWASH, EHAB & ENASFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(415) 479-3807
CITY:SAN RAFAELSTATE: CAZIP CODE:
94903
CAPACITY:14CENSUS: 6DATE:
07/02/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
08:45 AM
MET WITH:Licensee, Ehab & Enas HawwashTIME COMPLETED:
10:35 AM
NARRATIVE
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Licensing Program Analyst (LPA), Luis J. Gomez met with Licensees Ehab & Enas Hawwash. Purpose of the inspection was explained and was for an Annual/Random inspection. Present in the facility is both Licensees caring for 6 children. ( 2 Infants, 4 PreK). All Adults living in the home have Criminal Record Clearance in file. Licensee is within capacity limits of the License. Licensee’s home is a 3 bedroom, 2 bathroom, 1-level house. Hours of Operation are: Mon- Fri 6:00am-6:00pm. Daycare areas are: Playroom, Backyard Area and Bathroom #1Off Limit areas are: Kitchen, Bathroom #2, Bedroom #1, Bedroom #2 and Bedroom #3. There are no bodies of water in the daycare. LPA observed Chimney in the Daycare area is properly barricaded. LPA observed the following: Daycare area is clean, orderly, and equipped with age appropriate toys, puzzles and games for the children. Home has ample lighting and ventilation. Home has a telephone, a working smoke and carbon monoxide detector, and a fully charged fire extinguisher. LPA inspected yard for health and safety hazards. LPA observed all toys in the yard area are in good working condition. There are no poisons, detergents, cleaning products, or sharp objects accessible to daycare children. Licensee states there are no guns or weapons in the home. Licensee’s cardiopulmonary resuscitation certifications expires: 03/31/2021. Licensee conducted last emergency drill on 07/01/2019 and is properly logged. Licensee stated provides daily snacks and meals for children in care. All required postings are properly posted next to the main door. Licensee stated there are no pets in the home.

LPA reviewed children’s files and facility roster during today’s visit. LPA observed children’s files and facility roster are complete and up to date.

LPA observed a baby bouncer in the daycare area.

See Page 2. . .
SUPERVISOR'S NAME: Alma MaligTELEPHONE: (650) 266-8832
LICENSING EVALUATOR NAME: Luis GomezTELEPHONE: (650) 393-9134
LICENSING EVALUATOR SIGNATURE:

DATE: 07/02/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/02/2019
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, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: HAWWASH, EHAB & ENAS
FACILITY NUMBER: 214200067
VISIT DATE: 07/02/2019
NARRATIVE
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Page 2. . .
During inspection,
*Incidental Medical Services (IMS) policy was discussed.
*Licensee was reminded about having all Staff and Volunteers provide proof of immunization against influenza, pertussis, and measles or qualifies for an exemption.
*Licensee was reminded about the Provider Information Notices (PINs) on CCLD website.
*Licensee was reminded about Mandated Reporter Training available on CCLD website (www.ccld.ca.gov or www.mandatedreporterca.com)
*Licensee was given information regarding ‘Safe Sleep’ practices.

>See attached deficiencies page for deficiencies issued today under Title 22 Division 12 of the Ca. Code of Regulations.

>This report and rights to comment and appeal were discussed with Licensee. This report must be available in the facility for public review. Notice of site visit was observed being posted.
Licensee was advised any additional questions to call Office, M-F, 8am-5pm, 650-266-8800 or 1-844-538-8766. Website: www.cdss.ca.gov
SUPERVISOR'S NAME: Alma MaligTELEPHONE: (650) 266-8832
LICENSING EVALUATOR NAME: Luis GomezTELEPHONE: (650) 393-9134
LICENSING EVALUATOR SIGNATURE:

DATE: 07/02/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/02/2019
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, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: HAWWASH, EHAB & ENAS
FACILITY NUMBER: 214200067
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/02/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/05/2019
Section Cited
HSC
1596.846(b)(c)
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1596.846(b)(c) Baby Walkers. A baby walker shall not be kept or used on the premise of the child care facility. A baby walker means any article decribed in paragragh (4) subsection (a) of section of section 1500.86. of part of Title 16 of the federal regulations.
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Licensee will remove the bouncer from the daycare by the due date: 7/5/19.

Licensee will submit proof to licensing.
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The requirment is not met as evidenced by; LPA observed a baby bouncer in the daycare area. This is a potential health and safety risk to children in care.
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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: Alma MaligTELEPHONE: (650) 266-8832
LICENSING EVALUATOR NAME: Luis GomezTELEPHONE: (650) 393-9134
LICENSING EVALUATOR SIGNATURE:

DATE: 07/02/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/02/2019
LIC809 (FAS) - (06/04)
Page: 3 of 3