376100070-1-21-2020-51-CC-ERIA-BL2PSS-20200121103450

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 376100070
Report Date: 01/21/2020
Date Signed: 01/21/2020 10:34:57 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108

FACILITY NAME:	HASSAN, ABDISALAN FAMILY CHILD CARE		FACILITY NUMBER:	376100070
ADMINISTRATOR:	ABDISALAN HASSAN		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(206) 451-9010
CITY:	SAN DIEGO	STATE: CA	ZIP CODE:	92115
CAPACITY:	14	CENSUS: 0	DATE:	01/21/2020
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	08:50 AM
MET WITH:	Abdisalan Hassan		TIME COMPLETED:	10:45 AM

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	Licensing Program Analysts (LPA) Elizabeth Rivera conducted an announced pre-licensing inspection with applicant, Abdisalan Hassan. Purpose of the inspection is to ensure that the home is in compliance with standards established in CCR, Title 22, Division 12, Chapter 3, for Family Child Care Homes. This 2-bedroom, 1 bath home was toured and inspected to ensure environment is safe for the care and supervision of children. Applicant provided proof of rental agreement for review by the Department. Applicant will use the following areas for child care: living room, kitchen, dining room, and bathroom. Off limits areas include: bedroom 1, and bedroom 2. They are made inaccessible to day care children through the use of door locks, and doorknob covers. Applicant will utilize nearby park for outdoor activities. Applicant understands there must be direct supervision at all times while at the park with children. There are no bodies of water observed during time of visit. The fire extinguisher is rated 2A 10B:C and is located in the living room, smoke and carbon monoxide detectors meet requirements and are operational. All poisons, cleaners and hazardous items in the home are inaccessible to children through latches, locks, and/or placed up on high surfaces. Children’s toys and play equipment are available. Applicant states there are NO firearms or other weapons in the home. Applicant has completed the 8 hours of preventative health. Pediatric CPR and First Aid certifications expire on 11/2021. Applicant was advised that any new/additional adults must be cleared prior to working or residing in home. Immunization records per SB792 were reviewed and are in compliance for applicant. Per applicant operating hours are 24 hours, Monday through Friday and 6:00 a.m. to 6:00 p.m. Saturday through Sunday. Advised applicant no changes should be made to the home without prior notice and/or approval from Licensing. Applicant states he is financially secure to operate a family child care home for children and will comply with all regulations and laws governing family child care homes. Applicant completed Mandated Reporter AB1207 training on 12/17/19.

SUPERVISOR'S NAME: Renesha Pack	TELEPHONE: (619) 767-2155
LICENSING EVALUATOR NAME: Elizabeth Rivera	TELEPHONE: (619) 767-2232
LICENSING EVALUATOR SIGNATURE:	DATE: 01/21/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/21/2020

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, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108

FACILITY NAME: HASSAN, ABDISALAN FAMILY CHILD CARE	FACILITY NUMBER: 376100070
	VISIT DATE: 01/21/2020

NARRATIVE

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Applicant does not plan on providing Incidental Medical Services (IMS) to clients at this time and 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 New Provider Resource Packet was reviewed with the applicant including information on the following: SIDS, Safe Sleep, shaken baby, insurance, child abuse reporting, community resources, children’s records, facility records, required postings, immunization's, unusual incident report, roster, car seat law, visual for ratio/capacity, fire/disaster drill log and effects of lead exposure. Applicant was also informed the following items are prohibited during day care operating hours (walkers, exersaucers, jumpers and bouncy seats). Corporal punishment and smoking are not allowed in the day care. LPA and Applicant discussed California Megan's Law and LPA provided: www.meganslaw.ca.gov.

You can now sign up for Quarterly Updates and PINs for one or more programs through our DSS website. Just go to www.ccld.ca.gov and click on Child Care, go under Quick Links and Quarterly Updates, click on “Receive Important Updates” then put the email address in and choose which program(s) you would like to subscribe to and click “subscribe.”

The maximum capacity for a large family child care home: 12 children with no more than 4 infants (infants mean any children under 24 months) with an assistant; or (with landlord consent) 14 children with no more than 3 infants, 1 child in kindergarten or elementary school and 1 child at least age 6 including children under age 10 who live in the licensee's home. To access our Regulations and Forms please use our WEBSITE: http://ccld.ca.gov.

The following correction are needed prior to the issuance of the regular license:
(1) Post licensing forms
(2) Make wall heater inaccessible

Applicant must submit proof of correction to LPA by February 21, 2020. Once proof is received by the licensing agency, a Large Family Child Care Home License for 12 may be issued upon a final file review.

SUPERVISOR'S NAME: Renesha Pack	TELEPHONE: (619) 767-2155
LICENSING EVALUATOR NAME: Elizabeth Rivera	TELEPHONE: (619) 767-2232
LICENSING EVALUATOR SIGNATURE:	DATE: 01/21/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/21/2020

LIC809 (FAS) - (06/04)

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