<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376100533
Report Date: 02/18/2021
Date Signed: 02/18/2021 02:00:29 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:HASSAN, ASHA FAMILY CHILD CAREFACILITY NUMBER:
376100533
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 0DATE:
02/18/2021
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Asha HassanTIME COMPLETED:
01:52 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 2/18/21 at 1:30 PM Licensing Program Analyst (LPA) Keturah Lane, conducted an unannounced case management tele-inspection due to COVID-19 for a capacity increase with the applicant Asha Hassan via FaceTime. There were no children present during the inspection. The one-story house had been recently inspected for relocation by LPA Lane on 11/5/20. The fire extinguisher, carbon monoxide detector, and smoke detector meet requirements and are operational. Applicant has obtained landlord consent to care for 14 children. The home appears to be large enough to comfortably accommodate 14 children. Fire clearance was received on 12/9/20. 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. Records were not reviewed.
Applicant will be using the following rooms for childcare: living room, dining room, kitchen, bathroom, and bedroom #1 (aka children’s room). The following areas will be off limits: bedroom #2 and master bedroom/bath and are inaccessible by use of door-knob covers and locks. The home has a fenced backyard available for outdoor activities. Applicant is aware that next door neighbor has a pool that does not have a fence. Applicant understands that she will supervise outdoor activities at all times. LPA observed that storage shed in backyard was locked and inaccessible to children.

No deficiencies are cited. No corrections are needed; a license for 14 will be issued effective upon final file review.

An exit interview was conducted with applicant. A Notice of Site Visit (LIC9213) and Appeal Rights (LIC9058) will be sent along with the report (LIC809) via e-mail to the Licensee. Licensee will confirm receipt of this report via e-mail and the reply of confirmation will serve as the signature acknowledging these rights. The Notice of Site Visit (LIC9213) must remain posted for 30 days.
SUPERVISOR'S NAME: Monica CuddyTELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Keturah LaneTELEPHONE: (619) 767-2223
LICENSING EVALUATOR SIGNATURE:

DATE: 02/18/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/18/2021
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 1