376100596-1-11-2021-51-CC-KLAE-BX6QV7-20210111112951

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 376100596
Report Date: 01/11/2021
Date Signed: 01/11/2021 11:30:39 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:	WARSAME, SAINAB & ALI, AISHA FAMILY CHILD CARE		FACILITY NUMBER:	376100596
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY:	8	CENSUS: 0	DATE:	01/11/2021
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	10:00 AM
MET WITH:	Sainab Warsame		TIME COMPLETED:	11:20 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	On 1/11/21 at 10:00 AM, Licensing Program Analyst (LPA) Keturah Lane conducted an announced Pre-Licensing tele-inspection due to COVID-19 State of Emergency for relocation with the applicant. LPA Lane met with Ms. Warsame via Zoom. Also present in the home at time of inspection was Co-licensee Aisha Ali, Mustafa Hassan (helper) and Ms. Warsame’s grandchild. The one-story home (5 bedrooms, 3 bathrooms) was toured and inspected to ensure an environment safe for the care and supervision of children. 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 in the home. Applicant states that there are no weapons in the home. CPR and First Aid expire on 12/14/21 for Aisha Ali and 1/19/22 for Sainab Warsame. Preventative Health course was completed on 4/12/15 (Ms. Warsame) and 2/11/2018 (Ms. Ali). Applicants have not completed Lead Poison prevention training but have enrolled for a course on 1/14/21. Mandated Reporter training was completed on 1/3/21 & 1/4/21. 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. Ms. Warsame rents the home. The home appears to be large enough to comfortably accommodate a large family childcare license and applicants stated they understood the application process requirements. Required documents have been posted. Applicant will be using the following rooms for childcare: living room, kitchen, dining room, family room, bathroom #2 and bedroom #2. Off-limits areas include: Master bedroom with bathroom, bathroom #1, bedroom #3, bedroom #4, laundry room and garage. Off-limits are inaccessible through the use of door-knob covers. The applicant has sufficient toys and equipment available. The home has a fenced backyard available for outdoor activities. Visual supervision is required at all times when children are outside.

SUPERVISOR'S NAME: Monica Cuddy	TELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Keturah Lane	TELEPHONE: (619) 767-2223
LICENSING EVALUATOR SIGNATURE:	DATE: 01/11/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/11/2021

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: WARSAME, SAINAB & ALI, AISHA FAMILY CHILD CARE	FACILITY NUMBER: 376100596
	VISIT DATE: 01/11/2021

NARRATIVE

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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 Safe Sleep Regulations/SIDS and Shaken Baby Syndrome. LPA and Licensee discussed California Megan's Law and LPA provided: www.meganslaw.ca.gov. LPA reviewed COVID-19 guidelines and LPA Sutherland conducted Covid-19 tele-visit at previous facility on 9/9/20. LPA Lane provided Childcare licensing website: https://www.cdss.ca.gov/inforesources/community-care-licensing

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.

No corrections are needed; a provisonal license for 8 children will be issued effective today. LPA Lane will grant the regular license once Lead Poison Prevention training has been completed. Applicant understands that she must obtain landlord consent to care for more than 6 children. Applicant agreed to comply with all regulations and laws governing family child-care homes.

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 Cuddy	TELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Keturah Lane	TELEPHONE: (619) 767-2223
LICENSING EVALUATOR SIGNATURE:	DATE: 01/11/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/11/2021

LIC809 (FAS) - (06/04)

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