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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376619358
Report Date: 07/19/2019
Date Signed: 07/30/2019 09:44:52 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:WOLDU, LIA FAMILY CHILD CAREFACILITY NUMBER:
376619358
ADMINISTRATOR:LIA WOLDUFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(619) 255-9290
CITY:SAN DIEGOSTATE: CAZIP CODE:
92115
CAPACITY:14CENSUS: 8DATE:
07/19/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Lia Woldu & Fassil TsegayeTIME COMPLETED:
10:00 AM
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An unannounced annual inspection was conducted today by LPA, Nancy Diaz. Upon arrival LPA observed five children in care with the licensee, Lia Woldu and her husband, Fassil Tsegaye. Three more children arrived during the inspection. Their 14-year old daughter was also present today. Children were participating in various outdoor activities. LPA conducted a tour of the home to ensure the health and safety of children. Licensee is using the following areas for daycare: daycare room, daycare kitchen, hallway bathroom and TV room. The following areas are off-limits to children: all five bedrooms, main kitchen, office and the garage. These areas are inaccessible to children via barricade.
The licensee is present in the home and ensures that children in care are supervised at all times. The licensee has maintained capacity specified on the license. Each child has safe, healthful and comfortable accommodations, furnishings and equipment.

Licensee stated that she does not maintain weapons in the home. There were no bodies of water observed within the premises. All cleaners, toxics, medications and other hazardous substances are inaccessible to children in care via storage in locked shed. Fire extinguisher and smoke detectors present in the home meet State Fire Marshall standards. Carbon monoxide detector is also present in the home. The home is kept clean and orderly with sufficient ventilation for safety and comfort. Stairs are fenced/barricaded. The home provides toys, play equipment and materials. The home maintains a working telephone service, cellphone number is (619) 957-4442.

The home has a current roster of the children. The home conducts fire and disaster drills at least once every six months, and documents the date and time of each drill. Licensee documents immunizations and maintains and updates records for children in care. Licensee provides the child’s parent or representative with a copy of the Family Child Care Home Notification of parents’ rights.
SUPERVISOR'S NAME: Monica CuddyTELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Nancy DiazTELEPHONE: (619) 767-2207
LICENSING EVALUATOR SIGNATURE:

DATE: 07/19/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/19/2019
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 2
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: WOLDU, LIA FAMILY CHILD CARE
FACILITY NUMBER: 376619358
VISIT DATE: 07/19/2019
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The licensee and other personnel has completed training on Preventative Health Practices including Pediatric CPR and First aid. Licensee’s CPR & First Aid certificate are valid through July 2021.

A handout was provided to the licensee today on “Effects of Lead Exposure”. Licensee shall provide a copy of this handout to all the daycare parents.

There are no new adults living or working in the home over the age of 18 years. All individuals subject to criminal record review have obtained criminal record clearance or exemption prior to working, residing or volunteering.

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

LPA observed the Representative post the Notice of Site Visit in a prominent place. The Representative states it is understood that this notice must be posted for 30 days.



Community Care Licensing WEBSITE: http://www.ccld.ca.gov

NO DEFICIENCY CITED TODAY.
SUPERVISOR'S NAME: Monica CuddyTELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Nancy DiazTELEPHONE: (619) 767-2207
LICENSING EVALUATOR SIGNATURE:

DATE: 07/30/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/30/2019
LIC809 (FAS) - (06/04)
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