376100406-6-25-2020-51-CC-SSAA-BQWV6P-20200625160951

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 376100406
Report Date: 06/25/2020
Date Signed: 06/25/2020 04:10:43 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:	MUSSE, YASMIN FAMILY CHILD CARE		FACILITY NUMBER:	376100406
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY:	8	CENSUS:	DATE:	06/25/2020
TYPE OF VISIT:	Case Management - Other	UNANNOUNCED	TIME BEGAN:	02:30 PM
MET WITH:	Ysmin Musee		TIME COMPLETED:	04:00 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 06/25/2020 at 2:30pm, Licensing Program Analyst (LPA) Samantha Salunga conducted an unannounced case management virtual inspection with Licensee, Yasmin Musse. Licensee has requested an increase of capacity from having 8 children to 14 children. Fire clearance was granted on 06/15/2020. Due to COVID-19 state of emergency, this inspection was completed via video conferencing (Zoom). Licensee's 4 bedroom, 2 bathroom home was virtually toured and inspected to ensure an environment safe for the care and supervision of children. Also present were Licensee's two adult sons, Fuad Hason and Faysal Hasan, and one minor son. Licensee is utilizing the following areas for child care: master bedroom and bathroom, living room, dining room, and kitchen. Off limit areas include: the pool, 3 bedrooms and hall bathroom on the left side of the home, and the garage. Licensee utilizes backyard patio for outdoor activities. Required documents are posted. Licensee has an in-ground pool in the backyard. LPA observed the pool to be fenced (measured at least 5 ft.) with see through meshed fencing along with a self-latching gate that Licensee tested during televisit. It is to be noted there are solid windows (with no way of opening) located in the living room that lead directly to the pool, used as a form of barricade to make the pool inaccessible via inside the home. See file for pictures. Licensee stated there are no firearms or weapons in this home. Poisons, cleaning compounds, medications and other hazardous items are inaccessible to children. Fireplace is inaccessible via gate. There is a working fire extinguisher, a smoke detector, carbon monoxide detector. There are no stairs in the home. There is a working telephone and email address. Pediatric CPR/First Aid are current with an expiration date of 08/31/2021. There are no excluded individuals present at this home. Licensee was advised that any new/additional adults must be cleared prior to working or residing in home. Any minor upon his/her 18^th birthday must be fingerprinted within 30 days.

SUPERVISOR'S NAME: Tashima Daniel	TELEPHONE: (619) 767-2242
LICENSING EVALUATOR NAME: Samantha Salunga	TELEPHONE: (619) 767-2209
LICENSING EVALUATOR SIGNATURE:	DATE: 06/25/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/25/2020

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: MUSSE, YASMIN FAMILY CHILD CARE	FACILITY NUMBER: 376100406
	VISIT DATE: 06/25/2020

NARRATIVE

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Licensee has met all immunization requirements per SB792 and completed the AB1207 Mandated Reported Training. LPA reviewed capacity limitations, supervision, physical plant, reporting requirements, bodies of water, storage of hazardous items, Shaken Baby Syndrome, SIDS, emergency drills and childcare roster. LPA reminded Licensee that walkers, jumpers, exersaucers and bouncers are not permitted for use in the day care. Licensee was advised to regularly visit the Community Care Licensing WEB SITE: http://www.ccld.ca.gov/ for quarterly updates and updated regulation information. Duty Line was provided: (619) 767-2248. LPA discussed California Megan's Law and LPA provided: www.meganslaw.ca.gov

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

***Home was observed to be in compliance with Title 22 during televisit. Large Family Child Care Home license (14 capacity) is granted and effective today’s date 06/25/2020.

No deficiencies observed in the areas inspected during today's visit. NOTICE OF SITE VISIT IS TO BE POSTED FOR 30 DAYS.

A copy of this report and NOS was reviewed and will be e-mailed to Licensee. Licensee was advised that acknowledgement of the receipt of this report is to be received within twenty-four hours.

SUPERVISOR'S NAME: Tashima Daniel	TELEPHONE: (619) 767-2242
LICENSING EVALUATOR NAME: Samantha Salunga	TELEPHONE: (619) 767-2209
LICENSING EVALUATOR SIGNATURE:	DATE: 06/25/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/25/2020

LIC809 (FAS) - (06/04)

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