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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376100165
Report Date: 11/04/2019
Date Signed: 11/04/2019 12:14:34 PM

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:SHEIKHMOHAMED, RAHMO FAMILY CHILD CAREFACILITY NUMBER:
376100165
ADMINISTRATOR:RAHMO SHEIKHMOHAMEDFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(619) 763-0077
CITY:SAN DIEGOSTATE: CAZIP CODE:
92119
CAPACITY:14CENSUS: DATE:
11/04/2019
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Applicant Rahmo SheikhmohamedTIME COMPLETED:
12:20 PM
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LPA, Joelle Redding, met with Applicant Rahmo Sheikhmohamed, for the purpose of a Pre-Licensing inspection. Applicant has applied for a change of location on 10/9/19.

LPA toured the home. All required forms were posted. There is a working telephone on the premises. LPA did not note any hazardous items accessible to children. The fire extinguisher size (2A10BC or larger) meets requirements and is fully charged, located in the kitchen, mounted on the wall. The smoke detector (located in the ) hallway and carbon monoxide detector (located in the living room) are operational. Applicant’s Pediatric CPR/FA certification with Pediatric Plus is valid through 10/21. All adults living or working in the home have been fingerprint cleared and associated and immunization requirements have been met. Control of property was verified.

Applicant will be using the following areas for childcare: Living room, dining room, kitchen, one bedroom and hallway bathroom. Off limits areas of the home include: Master bedroom and bathroom and have been made inaccessible with the use of door knob covers. Applicant will be using the patio for outdoor space. Applicant was reminded of requirements for children’s records, child abuse reporting, unusual incident reporting, immunizations, criminal background clearance procedures and policies, posting requirements. SIDS, Shaken Baby Syndrome and Incidental Medical Services. Applicant was reminded that walkers, exersaucers, bouncy seats, jumpers, drop side cribs and napping portables are not to be used for day care. No smoking during in or around day care areas is prohibited.

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, an updated Plan of Operation that includes IMS must be submitted to the Department. The
SUPERVISOR'S NAME: Monica CuddyTELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Joelle ReddingTELEPHONE: (619) 767-2222
LICENSING EVALUATOR SIGNATURE:

DATE: 11/04/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/04/2019
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: SHEIKHMOHAMED, RAHMO FAMILY CHILD CARE
FACILITY NUMBER: 376100165
VISIT DATE: 11/04/2019
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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.

Currently, the fire extinguisher is behind the large cabinet in the dining room and not accessible. Applicant will submit pictures of the relocation. Upon receipt of the photos and final file review, the change of location will be granted and a new license will be sent for posting.

Community Care Licensing WEB SITE: http://www.ccld.ca.gov
SUPERVISOR'S NAME: Monica CuddyTELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Joelle ReddingTELEPHONE: (619) 767-2222
LICENSING EVALUATOR SIGNATURE:

DATE: 11/04/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/04/2019
LIC809 (FAS) - (06/04)
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