<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364842242
Report Date: 12/03/2024
Date Signed: 12/03/2024 03:35:06 PM

Document Has Been Signed on 12/03/2024 03:35 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE CC RO, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME:SHALABI FAMILY CHILD CAREFACILITY NUMBER:
364842242
ADMINISTRATOR/
DIRECTOR:		SHALABI, NADIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(909) 251-6118
CITY:ONTARIOSTATE: CAZIP CODE:
91762
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 11DATE:
12/03/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:45 AM
MET WITH:Nadia ShalabiTIME VISIT/
INSPECTION COMPLETED:
04:20 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
On the date and time listed, Licensing Program Analyst (LPA) Aman Lama arrived at the facility to conduct an annual inspection. Upon arrival, LPA was met with licensee, Nadia Shalabi. Licensee granted LPA access to the home, who then toured the on-limits indoor and outdoor areas of the facility. 8 children were present during todays inspection. There were 3 additional adults in the home during todays inspection, 2 of whom are licensees assistants. Licensee left the facility to pick up children, so LPA closed the inspection out with assistant, Mona Shalabi.

Normal days and hours of operation are listed as: Monday-Sunday, 5am-6pm.

OFF-LIMIT AREAS ARE LISTED AS FOLLOWS: Entire 2nd Floor and Garage.


· A working telephone is present and current phone number is on file.

· Appropriate fire extinguisher, smoke detector and carbon monoxide detector were all in working order.

· LPA observed hazards inaccessible to daycare child(ren). Licensee was reminded the difference between which items to keep under lock, which to keep behind a latch, and how to read labels to determine the difference.

· No guns/weapons currently kept in the home. All guns, weapons and ammunition must be key locked separately and made inaccessible, per Title 22 Regulations.

· Facility Sketch, Emergency Disaster Plan & Notification of Parent’s Rights poster were posted in the home.

· Mandated Reporter Training certificate for licensee and 1 assistant were on file and up to date.

· Pediatric CPR and First Aid Card for licensee and 1 assistant were also on file and up to date.

· Health & Safety Certificates for licensee has been completed and is on file.

SUPERVISORS NAME: Gilbert Sena
LICENSING EVALUATOR NAME: Aman Lama
LICENSING EVALUATOR SIGNATURE: DATE: 12/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/03/2024
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 16
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE CC RO, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME: SHALABI FAMILY CHILD CARE
FACILITY NUMBER: 364842242
VISIT DATE: 12/03/2024
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
26
27
28
29
30
31
32
·Bodies of water were not observed on property. Licensee is reminded that all bodies of water including ponds, above ground pools & spas, in-ground pools & spas, and some fountains must be properly fenced per Title 22 Regulations. The Department must be notified before and after installation of any of the above types of bodies of water. In addition, all wading pools or similar product must be emptied immediately after use and stored in an upright position.

· LPA observed age appropriate toys available for children.

· Documentation of last fire/disaster drill was available. Last drill conducted: 06-01-22.

· The Licensee was informed of their reporting requirements and is provided with the Regional Office’s Unusual Incident Reporting email mailbox: UnusualIncidentReportsDO09@dss.ca.gov

· Resident and/or staff records reviewed indicate that all adults who require caregiver background checks have received all required clearances or exemptions.

· The Licensee can submit transfer forms to associate new individuals or to disassociate someone from the facility at: Associations_Disassociations862@dss.ca.gov

-LPAs discussed the safe sleep regulations and discussed the Child Care Licensing Safe Sleep webpage as an additional resource at: https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep

-LPAs also informed licensee of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

-Licensee is not currently administering medications. Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes 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

SUPERVISORS NAME: Gilbert Sena
LICENSING EVALUATOR NAME: Aman Lama
LICENSING EVALUATOR SIGNATURE:

DATE: 12/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/03/2024
LIC809 (FAS) - (06/04)
Page: 2 of 16
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE CC RO, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME: SHALABI FAMILY CHILD CARE
FACILITY NUMBER: 364842242
VISIT DATE: 12/03/2024
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
26
27
28
29
30
31
32
- The licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

- To receive Provider Information Notices (PINs), go to the licensing webpage www.ccld.ca.gov, and click on the “Receive Important Updates” located on the right side of the page, immediately above the “Quick Links”. You can add your email address and choose which program(s) to receive PINs for.



See LIC809-D for cited deficiencies.

LPA Aman Lama informed licensees assistant, Mona Shalabi to let licensee know to provide a copy of this licensing report dated December 03, 2024 that documents any Type A citation(s) to parents/guardians of all children currently enrolled, or newly enrolled by the next business day or the next day the child(ren) is(are) in care. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification and kept on file for 12 months from the date of this report.


LPA Aman Lama also informed assistant, Mona Shalabi that this report dated December 03, 2024 document(s) (2) Type A citation(s) which shall be posted for 30 consecutive days as there is(are) immediate risk(s) to the health, safety, or personal rights of children in care.

- The Duty Officer is available to answer questions Monday – Friday; 8:00am to 5:00pm at: 951-782-4200.



The licensee, Irma Llamas confirmed that there are no Registered Sex Offenders living in the facility and/or using the facility address for their mailing address.

Exit interview was conducted and report was reviewed with the assistant, Irma Llamas.

A notice of site visit was given and must remain posted for 30 days.

SUPERVISORS NAME: Gilbert Sena
LICENSING EVALUATOR NAME: Aman Lama
LICENSING EVALUATOR SIGNATURE:

DATE: 12/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/03/2024
LIC809 (FAS) - (06/04)
Page: 3 of 16
Document Has Been Signed on 12/03/2024 03:35 PM - It Cannot Be Edited


Created By: Aman Lama On 12/03/2024 at 02:35 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: SHALABI FAMILY CHILD CARE
FACILITY NUMBER: 364842242

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/03/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
102425(a)
Infant Safe Sleep
(a) There shall be one crib or play yard for each infant who is unable to climb out of the crib or play yard.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Although LPA observed 2 cribs in the home, one was full of toys and the other one had diapers, multiple plush toys, a changing mat with blankets, and a small baby basket in it. Licensee stated that the 3 infants in care on this date, sleep on the couch when they do fall asleep. This poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 12/04/2024
Plan of Correction
1
2
3
4
Immediately, licensee will provide a safe sleep environment for the infants in care and submit a picture of this to licensing no later than the POC due date.
Type A
Section Cited
CCR
102425(i)
Infant Safe Sleep
If an infant falls asleep before being placed in a crib or play yard, the provider shall move the infant to a crib or play yard as soon as possible.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on observation and licensees own admission, licensee sleeps infants on the couch to sleep. LPA observed 3 infants in care during todays inspection. This poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 12/04/2024
Plan of Correction
1
2
3
4
LPA printed out the infant safe sleep regulations. Licensee agrees to read through it and send in a written understanding of what a safe sleep environment looks like. This is due to the department no later than the POC due date.
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:Gilbert Sena
LICENSING EVALUATOR NAME:Aman Lama
LICENSING EVALUATOR SIGNATURE:
DATE: 12/03/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/03/2024


LIC809 (FAS) - (06/04)
Page: 4 of 16
Document Has Been Signed on 12/03/2024 03:35 PM - It Cannot Be Edited


Created By: Aman Lama On 12/03/2024 at 02:35 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: SHALABI FAMILY CHILD CARE
FACILITY NUMBER: 364842242

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/03/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102417(g)(3)
Operation of A Family Child Care Home
(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (3) Where children are less than five years old are in care, stairs shall be fenced or barricaded.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on observation, the stairs were not barricaded. Although licensee has attempted to put a gate up with bungee cords on it, the other side of it does not hug onto the wall, making the stairs accessible to the children in care. This poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 12/06/2024
Plan of Correction
1
2
3
4
Licensee agrees to submit proof of a secured gate on the bottom of the stairs, no later than the POC due date.
Type B
Section Cited
CCR
102417(m)(3)
Operation of A Family Child Care Home
(3) A file of affidavits signed by each parent with a child enrolled in the home. The affidavit shall state that the parent has been informed that the family child care home does not carry liability insurance or a bond according to standards established by the state.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on record review, the licensee did not comply with the section cited above. 4 out of 4 children's files did not have an LIC282 on file. There were 2 LIC282's for other children (not reviewed on this date) that were mixed in with the files that were reviewed on this date. This poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 12/20/2024
Plan of Correction
1
2
3
4
Licensee agrees to submit proof of LIC282 for C1, C2, C3 and C4, no later than POC due date.
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:Gilbert Sena
LICENSING EVALUATOR NAME:Aman Lama
LICENSING EVALUATOR SIGNATURE:
DATE: 12/03/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/03/2024


LIC809 (FAS) - (06/04)
Page: 5 of 16
Document Has Been Signed on 12/03/2024 03:35 PM - It Cannot Be Edited


Created By: Aman Lama On 12/03/2024 at 02:36 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: SHALABI FAMILY CHILD CARE
FACILITY NUMBER: 364842242

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/03/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102425(c)
Infant Safe Sleep
An Individual Infant Sleeping Plan [LIC 9227 (3/20)] shall be completed for each infant up to 12 months of age the provider has in care and included in the infant's file at the facility.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on record review, the licensee did not comply with the section cited above. 2 out of 2 infants under 12 months of age did not have an LIC9227 on file, during review. This poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 12/20/2024
Plan of Correction
1
2
3
4
Licensee agrees to submit proof of LIC9227 for any infants that are under 12 months of age to the department, no later than the POC due date.
Type B
Section Cited
CCR
102425(j)(2)(D)(c)
Infant Safe Sleep
Documentation shall be maintained in the infant’s file and be available to the Department for review. Documentation shall include the following: Time of each 15-minute check

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on record review, the licensee did not comply with the section cited above. LPA observed "Sleep Charts" hanging on the wall. The last sleep check was dated: 08-30-2024. This poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 12/20/2024
Plan of Correction
1
2
3
4
Immediately, licensee agrees to begin 15 minute checks for any infants under 24 months of age. Proof of these logs are due by POC due date.
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:Gilbert Sena
LICENSING EVALUATOR NAME:Aman Lama
LICENSING EVALUATOR SIGNATURE:
DATE: 12/03/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/03/2024


LIC809 (FAS) - (06/04)
Page: 6 of 16