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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364813206
Report Date: 08/13/2019
Date Signed: 08/13/2019 12:07:52 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1605 EAST PALMDALE BLV, STE A
PALMDALE, CA 93550
FACILITY NAME:ALSAYEGH FAMILY CHILD CAREFACILITY NUMBER:
364813206
ADMINISTRATOR:ALSAYEGH, YASMEENFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(909) 475-8326
CITY:SAN BERNARDINOSTATE: CAZIP CODE:
92404
CAPACITY:14CENSUS: 0DATE:
08/13/2019
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME BEGAN:
09:45 AM
MET WITH:Yasmeen Alsayegh, TIME COMPLETED:
12:20 PM
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Licensing Program Analysts (LPA) Victoria Hunt and Aaron Mabika met with Yasmeen Alsayegh licensee, who guided analyst on a tour of the facility for an 3 year required inspection. During the time of this inspection licensee had no children in care. Residing in the home includes: adult (licensee) only. Per LIS, facility annual fees are current. All adults have been background cleared. Licensee was operating facility within ratio during the time of inspection. This facility operates no more than 23 hours per day.

This family child care facility is a single story home with 3 bedrooms, 2 bathrooms. There is a kitchen/dining room, living room, detached laundry room and an attached garage. The attached garage was observed to be locked during the time of this inspection. The garage is used for storage only, the garage is off limits to children.



Main care is conducted in the, living room, bedroom #3, and the front yard. In the living room LPAs observed a play yard and several small toys in which children have access to play with. There is a small table with age appropriate furniture (chairs) for the children to utilize. There is a security gate that prevents children from accessing the kitchen and the bedrooms located down the hallway. In Bedroom #3, LPAs observed age appropriate toys in which children have access to play with. Small cubbies were observed to be in the bedroom in which small toys were stored.


The kitchen was inspected to ensure hazardous and dangerous items were inaccessible to children. LPA observed in the kitchen area that a fire extinguisher (210ABC) was observed on a countertop. Licensee keeps a knife on top of a upper cabinet. Sharp objects and knives are inaccessible to children.
SUPERVISOR'S NAME: Mariela RamonTELEPHONE: (661) 789-6952
LICENSING EVALUATOR NAME: Victoria HuntTELEPHONE: (661) 568-8930
LICENSING EVALUATOR SIGNATURE:

DATE: 08/13/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/13/2019
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 4
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1605 EAST PALMDALE BLV, STE A
PALMDALE, CA 93550
FACILITY NAME: ALSAYEGH FAMILY CHILD CARE
FACILITY NUMBER: 364813206
VISIT DATE: 08/13/2019
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All cabinets in the kitchen were inspected and are free of hazardous and dangerous items. Children nap in the living room, LPA observed several (1) play yard and (4) mats in the play yard that were in good condition. Napping equipment observed to be on the premises in good and sanitary condition.

Children utilize a bathroom that located in the hallway. The bathroom was observed to be free and clear of hazardous items. The bathroom was observed to have working toilet, sink, and an ample supply of towels and soap accessible for the children to use. Lower cabinets were observed to be empty. The bathroom was clean, sanitized and in good repair.

All cleaning compounds/detergents were stored so that they are inaccessible to children. All cleaning compounds are stored in the laundry room which located in a separate area in the backyard. The laundry room was observed to be locked via a key. Children do not have access to the laundry room.

Per licensee children do not use the backyard. Children utilize the front yard for active play. The front yard is surrounded by chain link fencing that is at least 5 ft. The front yard is dirt/grass landscaping. There is a grassy area for active play. LPAs observed several toys on the front yard. There is a climbing structure that is securely anchored to the ground, a basket ball hoop, and a small play house with a slide. Underneath the play structure LPA's observed wooden chips.

LPA reviewed children records, records were complete.
SUPERVISOR'S NAME: Mariela RamonTELEPHONE: (661) 789-6952
LICENSING EVALUATOR NAME: Victoria HuntTELEPHONE: (661) 568-8930
LICENSING EVALUATOR SIGNATURE:

DATE: 08/13/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/13/2019
LIC809 (FAS) - (06/04)
Page: 2 of 4
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1605 EAST PALMDALE BLV, STE A
PALMDALE, CA 93550
FACILITY NAME: ALSAYEGH FAMILY CHILD CARE
FACILITY NUMBER: 364813206
VISIT DATE: 08/13/2019
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All required licensing document were posted. All electrical outlets were properly covered. The home is clean, orderly, comfortable and well ventilated. LPA observed a working smoke detector and carbon monoxide in operational condition. The fire extinguisher 2A10BC meets fire marshal standards and was operational during visit. The home has a working telephone service available. Per licensee, disaster/fire drills are conducted every six months. LPA observed disaster/fire drill log as current.

This home was clean, orderly and comfortable for children in care. This facility has a first aid kit on premises. LPA observed that licensee has a valid Pediatric CPR and First Aid card that expires on 01/2020 . Copy obtained for file. This facility has a current roster.

Per licensee there are no weapons or firearms on the premise.

Area off limit include: all bedrooms not used for child care, garage, and laundry room.

Licensee is not providing any medical services to children. Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

The following was discussed: Individuals who are 18 years of age or older living in the home must be finger print cleared prior to being in the home. Individuals within one month of their 18th birthday must be fingerprinted immediately or at least within 30 days or less of turning 18.
SUPERVISOR'S NAME: Mariela RamonTELEPHONE: (661) 789-6952
LICENSING EVALUATOR NAME: Victoria HuntTELEPHONE: (661) 568-8930
LICENSING EVALUATOR SIGNATURE:

DATE: 08/13/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/13/2019
LIC809 (FAS) - (06/04)
Page: 3 of 4
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1605 EAST PALMDALE BLV, STE A
PALMDALE, CA 93550
FACILITY NAME: ALSAYEGH FAMILY CHILD CARE
FACILITY NUMBER: 364813206
VISIT DATE: 08/13/2019
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There shall be no smoking, no infant walkers, johnny jumpers, exersaucers and any other item that falls into that category. Also discussed were earthquake, fire & disaster drills shall be documented at least once every six months. Posting requirements were discussed such as the posting of the Parent’s Rights poster in a visible location for the children’s authorized representatives. Children records requirements, mandated child abuse and injury/ death reporting, background check clearance transfer requirements, SIDS, Infants Safe Sleep on Back, and Never Shake A Baby were all discussed. Licensee agrees children shall be positioned for sleep on their back.

**Licensee informed to review updates/regulations for 2016/2017 on the department website: www.ccld.ca.gov ; AB 1207 - all child care employees must complete mandated reporter training beginning January 1, 2018; AB 1387 - and AB 2236 process to request a formal review of deficiency and establishes an appeal process for civil penalties; SB 792 - requires all staff and volunteers to show proof of immunization against influenza, pertussis and measles, and TB clearance, beginning September 1, 2016; AB 2231 Effective July 1, 2017 - Civil Penalty Amount changes.

No citations were issued during this inspection. This facility meets Title 22 Regulations. A copy of this report was read and discussed with licensee. Notice of Site Visit left at the facility.

SUPERVISOR'S NAME: Mariela RamonTELEPHONE: (661) 789-6952
LICENSING EVALUATOR NAME: Victoria HuntTELEPHONE: (661) 568-8930
LICENSING EVALUATOR SIGNATURE:

DATE: 08/13/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/13/2019
LIC809 (FAS) - (06/04)
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