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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376100430
Report Date: 09/27/2021
Date Signed: 09/27/2021 04:21:42 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:ORAHA, RAGHAD & YAQOOB, SALWAN FAMILY CHILD CAREFACILITY NUMBER:
376100430
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 2DATE:
09/27/2021
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
03:45 PM
MET WITH:Salwan Yaqoob and Raghad OrahaTIME COMPLETED:
04:30 PM
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On 9/27/21 at 3:45 PM Licensing Program Analyst (LPA) Adrian Mangina conducted a Plan of Correction visit to the child care home to follow-up on deficiency cited during a case management visit on 8/17/21. LPA met with Salwan Yaqoob and Raghad Oraha. Only License''s two minor children were in care. Proper supervision and ratios were observed.

LPA verified that the following were corrected:

1) Licensee has a current roster of children
2) Licensee has child files for 33 of 33 children who were in Licensee's care.

No deficiencies were cited during this visit.

Licensee was provided with a copy of this report (LIC809) and Appeal Rights (LIC9058). Their signature on this form is acknowledgement of receipt. A Notice of Site Visit (LIC9213)was also provided and must be posted for 30 consecutive days.
SUPERVISOR'S NAME: Renesha PackTELEPHONE: (619) 767-2155
LICENSING EVALUATOR NAME: Adrian L ManginaTELEPHONE: (619) 767-2209
LICENSING EVALUATOR SIGNATURE:

DATE: 09/27/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/27/2021
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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