376100414-6-18-2021-51-CC-TBLK-C44TDQ-20210618143843

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 376100414
Report Date: 06/18/2021
Date Signed: 06/18/2021 02:38:52 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:	ABDI, ZAMZAM FAMILY CHILD CARE		FACILITY NUMBER:	376100414
ADMINISTRATOR:	ZAMZAM ABDI		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(619) 808-6167
CITY:	SAN DIEGO	STATE: CA	ZIP CODE:	92119
CAPACITY:	14	CENSUS: 1	DATE:	06/18/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	01:15 PM
MET WITH:	Zamzam		TIME COMPLETED:	02:45 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	Licensing Program Analyst (LPA), Tyra Block, conducted an unannounced Annual Inspection with the Licensee. LPA assessed for COVID-19 prior to entering the facility. Present were the Licensee and 1 day care child. The first floor apartment home was toured and inspected to ensure an environment safe for the care and supervision of children. Proper supervision and ratios were observed. The fire extinguisher, carbon monoxide detector, and smoke detector meet requirements and are operational. Cleaning supplies and detergent were observed on the patio accessible to children then stored in a locked closet. There are no bodies of water on the property. and Licensee states that there are no weapons in the home. 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. Licensee’s First Aid and CPR certifications expire on 12/2021. Proof of Mandated Reporter Training was not initially provided but will be submitted to LPA. Licensee and staff meet immunization requirements and Licensee maintains emergency records for children. Licensee has provided adequate space for the children to eat, sleep and play within the home. Areas used for child care include Living Room, Dining Room, Kitchen, hallway Bathroom, Bedroom, and Patio. Off limits areas include the Master Bedroom and Master Bathroom. Off-limit areas are inaccessible through the use of door knob cover and window lock on sliding glass door affixed at the top. Licensee's cellphone is available for use at the facility. The licensee has age appropriate toys and equipment available for children to use. The fenced patio is gated and available if needed to access in emergency. Provider is hereby reminded of the following: Report suspected child abuse and neglect, maintain children’s records according to regulation, post all required forms, ensure that all adults living or working in the home have criminal background clearances to avoid civil penalties associated with this requirement; corporal punishment, smoking, exersaucers, bouncy seats, walkers, and jumpers are not allowed in day care. All equipment that is used should be used only as intended by the manufacturer. LPA and Licensee discussed California Megan's Law and LPA provided: www.meganslaw.ca.gov. Child Care Guidance was also discussed.

SUPERVISOR'S NAME: Tashima Daniel	TELEPHONE: (619) 767-2242
LICENSING EVALUATOR NAME: Tyra Block	TELEPHONE: (619) 767-2201
LICENSING EVALUATOR SIGNATURE:	DATE: 06/18/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/18/2021

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: 06/18/2021

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.

Please see LIC809D for Type B citation issued during today's visit.

The licensee was provided a copy of their appeal rights (LIC 9058 12/15) and their signature on this form acknowledges receipt of these rights. LPA provided notice of site visit and observed it being posted at the facility.

SUPERVISOR'S NAME: Tashima Daniel	TELEPHONE: (619) 767-2242
LICENSING EVALUATOR NAME: Tyra Block	TELEPHONE: (619) 767-2201
LICENSING EVALUATOR SIGNATURE:	DATE: 06/18/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/18/2021

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
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 06/18/2021

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 06/18/2021 Section Cited	1 2 3 4 5 6 7	102417(g)(4)-Operation of a Family Child Care Home: Poisons, detergents, cleaning compounds medicines...and other items which could pose a danger if readily available to children shall be stored where they are inaccessible to children. This requirement was not met as evidenced by:
	8 9 10 11 12 13 14	Based on observation cleaning products were on the washer/ dryer and storage bin on the patio, accessible to children which poses a potential health, safety, or personal rights risks to children in care.	8 9 10 11 12 13 14
	1 2 3 4 5 6 7
	1 2 3 4 5 6 7

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME: Tashima Daniel	TELEPHONE: (619) 767-2242
LICENSING EVALUATOR NAME: Tyra Block	TELEPHONE: (619) 767-2201
LICENSING EVALUATOR SIGNATURE:	DATE: 06/18/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/18/2021

LIC809 (FAS) - (06/04)

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