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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376100171
Report Date: 11/05/2019
Date Signed: 11/05/2019 02:24:36 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:ALKHALEIF, ASMAA FAMILY CHILD CAREFACILITY NUMBER:
376100171
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 0DATE:
11/05/2019
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
01:20 PM
MET WITH:Asmaa Alkhaleif, Applicant TIME COMPLETED:
02:35 PM
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Licensing Program Analyst (LPA) Michelle Hood conducted an announced pre-licensing inspection for a change of location 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 3-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, bedroom 2, bedroom 3, and bathroom 1. Off limits areas include: garage, backyard and bedroom 1. They are made inaccessible to day care children through the use of doorknob covers, and door latches. Applicant will utilize near by park for outdoor activities. Applicant understands there must be direct supervision while at park with children in care. Applicant understands facility backyard can not be used for outdoor play, until cleaned. Applicant understands she must notify her assigned LPA once landlord starts construction in backyard. There are no bodies of water present at time of inspection. The fire extinguisher is rated 2A 10B:C, smoke and carbon monoxide detectors meet requirements and are operational. All poisons, cleaners and hazardous items in the home are inaccessible to children and 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 10/2021. Required documents are posted. Applicant and all adults residing in the home 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 applicant.

SUPERVISOR'S NAME: Joe CarrascoTELEPHONE: (619) 767-2243
LICENSING EVALUATOR NAME: Michelle HoodTELEPHONE: (691) 767-2241
LICENSING EVALUATOR SIGNATURE:

DATE: 11/05/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/05/2019
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: ALKHALEIF, ASMAA FAMILY CHILD CARE
FACILITY NUMBER: 376100171
VISIT DATE: 11/05/2019
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Applicant is exempt from Mandated Reporter AB1207 training certification due to applicant having limited English proficiency, applicant’s primary language is Arabic. Per applicant operating hours are 7:00 a.m. to 12:00 a.m., Monday through Sunday. 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.

Applicant does not plan on providing IMS to clients. 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 Resource Packet was reviewed with the applicant including information on the following: SIDS, shaken baby, children’s records, facility records, required postings, immunization's, unusual incident report, roster, car seat law, visual for ratio/capacity, fire/disaster drill log. 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.

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.

Applicant's daughter interpreted and explained inspection report to applicant in Arabic, applicant stated she understood.

The following correction is needed prior to the issuance of the regular license:
1. Items in bathroom must be made inaccessible to children in care.
2. Barricade wall heater or provide letter from SDG &E.

Once proof is received by the licensing agency, a Small Family Child Care Home License for 8 may be issued upon a final file review.
SUPERVISOR'S NAME: Joe CarrascoTELEPHONE: (619) 767-2243
LICENSING EVALUATOR NAME: Michelle HoodTELEPHONE: (691) 767-2241
LICENSING EVALUATOR SIGNATURE:

DATE: 11/05/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/05/2019
LIC809 (FAS) - (06/04)
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