376100533-12-13-2021-51-CC-KLAE-C9NRX5-20211213122410

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 376100533
Report Date: 12/13/2021
Date Signed: 12/13/2021 12:24:21 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 CARE		FACILITY NUMBER:	376100533
ADMINISTRATOR:	ASHA HASSAN		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(619) 382-7548
CITY:	SAN DIEGO	STATE: CA	ZIP CODE:	92115
CAPACITY:	14	CENSUS: 1	DATE:	12/13/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	10:06 AM
MET WITH:	Asha Hassan		TIME COMPLETED:	12:35 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 12/13/21 at 10:06 AM, Licensing Program Analyst (LPA) Keturah Lane conducted an unannounced annual inspection with the Licensee. Upon arrival, LPA met with Licensee, Asha Hassan and provided the Inspection Checklist (LIC126). The one-story home was toured and inspected to ensure an environment safe for the care and supervision of children. Present were the Licensee and her minor daughter. There were no daycare children in care at time of inspection. Licensee states she takes care of the children after school in the afternoons. The fire extinguisher, carbon monoxide detector, and smoke detector meet requirements and are operational. All hazardous items were latched/locked and secured out of reach of children. There are no bodies of water on the property. 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 was reminded that all adults 18 and over living or working in the home, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated. Licensee’s First Aid and CPR certifications expire on 1/16/23. Helper’s First Aid and CPR certifications are not valid as they are not EMSA approved. LPA discussed with Licensee that helper Salma Omar will need to renew her first/aid cpr certification with an EMSA approved program. Licensee and staff meet immunization requirements and have completed Mandated Reporter Training which expires 8/28/22 (Helper Salma Omar’s mandated reporter expires on 9/29/23). Licensee maintains emergency records for children. Required documents are posted. LPA reviewed documentation of emergency drills and last (earthquake/fire) drill was conducted on 11/21/21. (continued on LIC809-C...)

SUPERVISOR'S NAME: Monica Cuddy	TELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Keturah Lane	TELEPHONE: (619) 767-2223
LICENSING EVALUATOR SIGNATURE:	DATE: 12/10/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/10/2021

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: HASSAN, ASHA FAMILY CHILD CARE	FACILITY NUMBER: 376100533
	VISIT DATE: 12/13/2021

NARRATIVE

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Licensee has provided adequate space for the children to eat, sleep and play within the home. Areas used for childcare include: living room, dining room, kitchen, bedroom #1, bathroom and hallways. Off limits areas include: master bedroom and bedroom #2 and are inaccessible through use of door-knob covers and locks. There is a working phone at the facility. The licensee has sufficient age appropriate, safe, toys and equipment available. The home has a fenced backyard available for outdoor activities. Fence was in good repair and outdoor shed was locked. Verification of control of property is on file. Property owner/Landlord notification and consent are on file.

Provider is hereby reminded of the following: Report suspected child abuse and neglect, maintain children’s records according to regulation, 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. LPA Lane reviewed Covid-19 guidelines with Licensee and provided Covid-19 resources. LPA Lane directed Licensee to website: https://www.cdss.ca.gov/inforesources/community-care-licensing to receive important updates and information.

LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed licensee of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

No deficiencies are cited.

(Continued on LIC809-C...)

SUPERVISOR'S NAME: Monica Cuddy	TELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Keturah Lane	TELEPHONE: (619) 767-2223
LICENSING EVALUATOR SIGNATURE:	DATE: 12/13/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/13/2021

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: HASSAN, ASHA FAMILY CHILD CARE	FACILITY NUMBER: 376100533
	VISIT DATE: 12/13/2021

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.

Exit interview conducted and report was reviewed with the licensee, Asha Hassan. Notice of Site Visit was given and must remain posted for 30 days.

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process

SUPERVISOR'S NAME: Monica Cuddy	TELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Keturah Lane	TELEPHONE: (619) 767-2223
LICENSING EVALUATOR SIGNATURE:	DATE: 12/13/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/13/2021

LIC809 (FAS) - (06/04)

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