376100596-12-1-2021-51-CC-ASUD-C9ANFJ-20211201092536

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 376100596
Report Date: 12/01/2021
Date Signed: 12/01/2021 09:26:24 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: 1	DATE:	12/01/2021
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME BEGAN:	08:37 AM
MET WITH:	Sainab Warsame		TIME COMPLETED:	09:40 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 12/1/21 at 8:37 am LPA Annette Sutherland conducted an unannounced case management site visit for a capacity increase. This visit is to verify that the licensee remains in substantial compliance with the health & safety standards as required by regulations governing family childcare homes. LPA met with licensee Sainab Warsame and daughter Aisha Ali was also present. Licensee's minor grandson was also present. Licensee has all appropriate forms posted. LPA confirmed with licensee that all adults residing/working in the home have criminal record/TB clearances. 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 9/7/21. First Aid and CPR certifications expire on 1/19/22 for Sainab and 12/14/21 for Alisha. Children’s records were reviewed and found to be in order. Licensee has practiced fire/emergency drills with day-care children according to regulations. The one story home (5 bedrooms, 3 bathrooms) was toured, the following areas are used for day-care: living room, kitchen, dining room, family room, bathroom #2 and bedroom #2, and backyard. Off-limits areas include: Master bedroom with bathroom, bathroom #1, bedroom #1,3, and 4, laundry room and garage. Off-limits are inaccessible through the use of door-knob covers. Drawers and lower cabinets in kitchen are either latched or do not contain any hazardous items. There is an operational smoke alarm, carbon monoxide detector and fire extinguisher maintained in the home. There are adequate age appropriate toys, books, games, napping mats, and hygienic diaper changing equipment. There are no firearms present on the premises as stated by licensee. Furthermore, there are no bodies of water. The outdoor play area is a fully fenced backyard, which is free of hazards and has sufficient toys. Per licensee, operating hours are from 6:00- 10:30 pm; 7 days a week. LPA reviewed the following: required departmental documents, regulation highlights, community resources, capacity limitations, supervision, clearances, emergency drills, heat related illness, child passenger law, unusual incidents, mandated reporting, Assembly Bill 633, SIDS, Safe sleep regulations, Shaken Baby Syndrome, Megan's law and Covid information. Applicant is reminded that corporal punishment, smoking, walkers, exersaucers, jumpers and bouncy seats shall never be permitted during day-care operation. Any equipment used should only be used according to the manufacturer recommendations. Continued on LIC 809 C

SUPERVISOR'S NAME: Monica Cuddy	TELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Annette Sutherland	TELEPHONE: (619) 629-8751
LICENSING EVALUATOR SIGNATURE:	DATE: 12/01/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/01/2021

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: 12/01/2021

NARRATIVE

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For licensing regulations/updates/forms, go to webpage http://www.ccld.ca.gov

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 deficiencies are cited. No corrections are needed; a license for 14 children will be issued effective today.

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: Monica Cuddy	TELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Annette Sutherland	TELEPHONE: (619) 629-8751
LICENSING EVALUATOR SIGNATURE:	DATE: 12/01/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/01/2021

LIC809 (FAS) - (06/04)

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