376100414-6-11-2020-51-CC-TBLK-BQGPJ5-20200611112057

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 376100414
Report Date: 06/11/2020
Date Signed: 06/11/2020 11:21:11 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:	ABDI, ZAMZAM FAMILY CHILD CARE		FACILITY NUMBER:	376100414
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY:	8	CENSUS: 0	DATE:	06/11/2020
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	10:11 AM
MET WITH:	Zamzam Abdi		TIME COMPLETED:	11:30 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 Analyst (LPA), Tyra Block, conducted an announced Pre-Licensing tele-inspection for relocation with Zamzam Abdi, due to COVID-19 . The single story apartment home was toured and inspected to ensure an environment safe for the care and supervision of children. The fire extinguisher (3A40BC), carbon monoxide detector, and smoke detector meet requirements and are operational. All hazardous items were locked and secured out of reach of children. There are no bodies of water in the home. Applicant states that there are no weapons in the home. CPR and First Aid expire on 12/31/2021. A review of staff records on this date indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse clearances or exemptions. Staff immunization requirements were met. Applicant rents the home and has provided proof of control of property. Fire clearance granted on 5/20/20. Applicant will be using the following rooms for childcare: Living Room, Dining Room, Kitchen, hallway Bathroom, Bedroom, and Patio. Off limits areas include: the Master Bedroom and Master Bathroom, and the Patio with the washer and dryer. Off-limit areas are inaccessible through the use of door knob cover and window lock on sliding glass door affixed at the top. The applicant has some toys and equipment available and states she has ordered additional. The fenced patio is gated and available for outdoor activities. Applicant was reminded of requirements for children’s records, child abuse, and unusual incident reporting, immunizations, adults living or working in the home and associated civil penalties, applicant was also reminded that corporal punishment, smoking, walkers, exersaucers, bouncy seats and jumpers are not allowed in day care. All equipment that is used should be used only as intended by the manufacturer. LPA provided information regarding Effects of Lead and COVID-19. Safe Sleep Regulations/SIDS and Shaken Baby Syndrome were also discussed. LPA and Licensee discussed California Megan's Law and LPA provided: www.meganslaw.ca.gov.

SUPERVISOR'S NAME: Monica Cuddy	TELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Tyra Block	TELEPHONE: (619) 767-2201
LICENSING EVALUATOR SIGNATURE:	DATE: 06/11/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/11/2020

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: ABDI, ZAMZAM FAMILY CHILD CARE	FACILITY NUMBER: 376100414
	VISIT DATE: 06/11/2020

NARRATIVE

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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.

Applicant is 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.Southern California Child Care Advocate information was provided and applicant was encouraged to subscribe through the CCLD website in order to be placed on an email list for updated regulation information. Advocate information was provided: (714) 703-2800 or childcareadvocatesprogram@dss.ca.gov.

The following corrections are needed before a license for 14 children can be issued:

Corners of the coffee table in the living room will need to be made safe
Parent's Rights Poster and Earthquake Preparedness posted
Proof of Landlord Notification

The licensee was provided a copy of their appeal rights (LIC 9058 12/15) and will submit an email confirmation to acknowledge receipt of these rights.

SUPERVISOR'S NAME: Monica Cuddy	TELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Tyra Block	TELEPHONE: (619) 767-2201
LICENSING EVALUATOR SIGNATURE:	DATE: 06/11/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/11/2020

LIC809 (FAS) - (06/04)

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