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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376100136
Report Date: 10/28/2019
Date Signed: 10/28/2019 10:41:54 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:HASHI, SAFIYO FAMILY CHILD CAREFACILITY NUMBER:
376100136
ADMINISTRATOR:SAFIYO HASHIFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(619) 451-2040
CITY:EL CAJONSTATE: CAZIP CODE:
92021
CAPACITY:14CENSUS: 0DATE:
10/28/2019
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Safiyo Hashi, ApplicantTIME COMPLETED:
11:00 AM
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Licensing Program Analyst (LPA) Michelle Hood conducted an announced pre-licensing change of location inspection with applicant. 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 control of property for review by the Department. Applicant will use the following areas for child care: living room, kitchen, dining room, bathroom, and bedroom 1. Off limits areas include: backyard, and bedroom 2. They are made inaccessible to day care children through the use of doorknob covers, and door latches. Applicant will utilize nearby park for outdoor activities until backyard is complete. 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 kitchen, 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 11/2020. Required documents are posted. Applicants have been cleared for criminal record and child abuse index clearances. Applicant was advised that any new/additional adults must be cleared prior to working or residing in home. Any minor upon his/her 18th birthday must be fingerprinted within 30 days. Immunization records per SB792 were reviewed and are in compliance for applicants. Per applicant operating hours are Monday through Sunday 6:00 a.m. to 12:00 a.m. Advised applicant no changes should be made to the home without prior notice and/or approval from Licensing. Applicant states they are financially secure to operate a family child care home for children and will comply with all regulations and laws governing family child care homes.

SUPERVISOR'S NAME: Jason GarayTELEPHONE: (559) 243-4588
LICENSING EVALUATOR NAME: Michelle HoodTELEPHONE: (619) 767-2241
LICENSING EVALUATOR SIGNATURE:

DATE: 10/28/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/28/2019
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 2
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: HASHI, SAFIYO FAMILY CHILD CARE
FACILITY NUMBER: 376100136
VISIT DATE: 10/28/2019
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Applicant does not plan on providing IMS to clients at this time. 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 New Provider Resource Packet was reviewed with the applicant including information on the following: SIDS, 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 Safe Sleep, California Megan's Law and LPA provided: www.meganslaw.ca.gov.

Applicant will request to be on the distribution list for child care updates. 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 small family child care home: 4 infants only (infants mean any children under 24 months); or 6 children with no more than 3 infants; or (with landlord consent) 8 children with no more than 2 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.

A Small Family Child Care Home License for 8 may be issued upon a final file review.
SUPERVISOR'S NAME: Jason GarayTELEPHONE: (559) 243-4588
LICENSING EVALUATOR NAME: Michelle HoodTELEPHONE: (619) 767-2241
LICENSING EVALUATOR SIGNATURE:

DATE: 10/28/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/28/2019
LIC809 (FAS) - (06/04)
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