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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364830475
Report Date: 02/20/2020
Date Signed: 02/20/2020 01:24:40 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME:ABDALRAHIM FAMILY CHILD CAREFACILITY NUMBER:
364830475
ADMINISTRATOR:ABDALRAHIM LABRINAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(760) 885-9582
CITY:VICTORVILLESTATE: CAZIP CODE:
92392
CAPACITY:14CENSUS: 0DATE:
02/20/2020
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
11:49 AM
MET WITH:Labrina AbdalrahimTIME COMPLETED:
01:45 PM
NARRATIVE
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Licensing Program Analysts (LPAs) Neal and Flores met with licensee, Labrina Abdalrahim for the purpose of an Annual/Random inspection. This is a 3 bedroom, 2 bathroom apartment home with kitchen and living room. There is a gated pool on the complex premises. There were no child care children were present during this inspection. Incidental Medical Services (IMS) were discussed.

Main care is provided in the child care room down the hall to the right (next to the master bedroom) and the living room. Children use the bathroom located near the child care room entrance on the right. Master bedroom is made off limits by lock. There is no fireplace on the premises. The home was inspected inside and out for safety, comfort, cleanliness, telephone service, heating and ventilation, inaccessibility to poisons, detergents, cleaning compounds (under kitchen sink, safety latch), medicines (master bedroom and upper kitchen cabinet), and hazardous items that can pose a danger to children. Sharp knives are in butcher block in high kitchen cabinet. Facility roster is complete and maintained current. Fire/earthquake drills are also current. LPA observed play equipment and other age appropriate toys. Licensee has no pets.

LPA observed a large outdoor play structure with sand underneath within walking distance on the apartment complex grounds. Licensee states only occasionally she takes the children to the playground for active play. The pool is on the other side of the play structure and is gated. Licensee states she does not take the children into the pool area.

SUPERVISOR'S NAME: Mariela RamonTELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Jazelle NealTELEPHONE: (661) 568-8945
LICENSING EVALUATOR SIGNATURE:

DATE: 02/20/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/20/2020
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, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: ABDALRAHIM FAMILY CHILD CARE
FACILITY NUMBER: 364830475
VISIT DATE: 02/20/2020
NARRATIVE
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Per licensee, there are no weapons or firearms of any kind in the facility at this time. The LPAs did not observe any weapons. Children nap in the living room room area. Mats are provided. The required fire extinguisher (2A10BC), smoke detector and carbon monoxide detector are in operable condition. Home has central AC and heat. Licensee's Pediatric CPR/First Aid expires 11/3/2020. Licensee has a First Aid kit which is kept in the children's bathroom cabinet (child locked). LPA observed the parent board and required documents are posted. Licensee was reminded that Mandated Reporter Training for child care must be completed by licensees and any adults assisting in the child care every 2 years.

The following was discussed with the licensee:
Mandatory Forms for the children’s files and provider’s files, Requirements for fire drills, earthquake drills and documentation for both. Role and responsibilities of being a mandated reporter were reviewed. Licensee reminded that 100% supervision is required at all times to children in care. The licensee was advised how to access forms and Regulations for Family Child Care online at www.ccld.ca.gov . Licensee was made aware that it is her responsibility to know the regulations as well as anyone who assists in providing care. The licensee was advised that inaccessibility of hazards must be constantly reassessed depending on the children in care. Licensing must have the facility’s phone number at all times; if the phone number is changed, licensing must be notified. Regulation prohibits the smoking of tobacco in a private residence that is licensed as a family child care home and in those areas of the family child care home where children are present (24/7 ban). State law prohibits baby walkers, bouncy seats, exersaucers and any other items that fall into that category.

Requirements for fingerprint clearances and associations were discussed with the licensee. Licensee can be cited a civil penalty of $100 per day, up to $500.00 for the 1st offense and up to $3000.00 for the 2nd offense within a 12 month period, PER PERSON.
SUPERVISOR'S NAME: Mariela RamonTELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Jazelle NealTELEPHONE: (661) 568-8945
LICENSING EVALUATOR SIGNATURE:

DATE: 02/20/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/20/2020
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, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: ABDALRAHIM FAMILY CHILD CARE
FACILITY NUMBER: 364830475
VISIT DATE: 02/20/2020
NARRATIVE
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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

Licensee was advised of the requirement to report unusual incidents and/or injuries to the parent/guardian and Licensing within the time frame specified by the regulation and on the form LIC624B. Handout of Safe Sleep Concepts was given to the licensee.



Licensee was advised that the Notice of Site Visit must be posted at the entrance of the facility for a period of 30 days. If a serious violation is cited, a copy of the licensing report (LIC809 or LIC9099) must also be posted for 30 days. If these requirements are not met, civil penalties in the amount of $100 per violation will be assessed. Copies of the reports must also be provided to each parent and a copy of the Acknowledgment of receipt of licensing report (LIC9224) must be kept in each child's file. In addition, any child enrolled within the following 12 months must also receive a copy of the Type A Citation.

1 Type A deficiency was cited during this inspection. See 809D for details. Appeal Rights were given.

Exit interview was conducted, report was read and provided to Licensee on this date.
SUPERVISOR'S NAME: Mariela RamonTELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Jazelle NealTELEPHONE: (661) 568-8945
LICENSING EVALUATOR SIGNATURE:

DATE: 02/20/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/20/2020
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, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: ABDALRAHIM FAMILY CHILD CARE
FACILITY NUMBER: 364830475
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/20/2020
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
02/21/2020
Section Cited

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102370(d)(1) Criminal Record Clearance. All individuals subject to a criminal record review as specified in Section 1596.871 prior to working, residing or volunteering in a licensed home, shall obtain a California
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clearance or a criminal record exemption as required by the Department. Requirement not met as evidenced by Adult #1 helped take day care child to school in morning which is an immediate health and safety risk.
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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: Mariela RamonTELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Jazelle NealTELEPHONE: (661) 568-8945
LICENSING EVALUATOR SIGNATURE:
DATE: 02/20/2020
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/20/2020
LIC809 (FAS) - (06/04)
Page: 4 of 4