376623856-7-19-2019-20-CC-JARL-BE8P7H-20190719110358

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 376623856
Report Date: 07/19/2019
Date Signed: 07/19/2019 11:04:07 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:	HAYDER, SAHRA FAMILY CHILD CARE		FACILITY NUMBER:	376623856
ADMINISTRATOR:	HAYDER, SAHRA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(619) 565-4745
CITY:	SAN DIEGO	STATE: CA	ZIP CODE:	92105
CAPACITY:	14	CENSUS: 0	DATE:	07/19/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	09:45 AM
MET WITH:	Sahra Hayder		TIME COMPLETED:	11:00 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	Licensing Program Analyst (LPA) Jo Ann Legaspi conducted an unannounced inspection with the Licensee. The home was toured and inspected to ensure a safe environment for the care and supervision of children. The daycare is a four (4) bedroom, two (2) bathroom single family home. Present in the home was the Licensee and no daycare children. The fire extinguisher, carbon monoxide, and smoke detectors satisfy requirements and are operational. The last safety drill was on 06/07/2019. Hazardous items were secured inaccessible to children. There are no bodies of water in the home. There are no weapons in the home, per the Licensee. A review of staff records indicates all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse clearances or exemptions. Reviewed children records were observed to be complete. Licensee has provided adequate space for the children to eat, sleep and play within the home. Livingroom, family room and one (1) bathroom are used for child care. The kitchen is barricaded with a child safety gate. The Licensee has sufficient toys and available equipment. All equipment that is used should be used only as intended by the manufacturer. The home has a fenced backyard available for outdoor activities. The Licensee acknowledges that continuous, visual supervision will be expended whenever children are engaged in outdoor activities. LPA provided and reviewed with Licensee PIN 19-06-CCP, which states the US Consumer Product Safety Commission has issued a safety recall of specific sleepers due to a number of infant deaths. LPA provided Licensee with Provider Information Notice (PIN) 19-02-CCP regarding Safe Sleep Awareness, additional written information and information resources about safe sleep techniques. LPA and Licensee discussed those methods of protected slumber. LPA provided and discussed with Licensee PIN 19-08-CCP, which describes new immunization requirements issued by the Department of Public Health. Licensee was also provided with written information regarding lead exposure as described in Assembly Bill 2370. LPA further

SUPERVISOR'S NAME: Tulam Vu	TELEPHONE: (619) 767-2205
LICENSING EVALUATOR NAME: JoAnn R Legaspi	TELEPHONE: (619) 767-2239
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 3

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: HAYDER, SAHRA FAMILY CHILD CARE	FACILITY NUMBER: 376623856
	VISIT DATE: 07/19/2019

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
26
27
28
29
30
31
32

provided and discussed with Licensee PIN 19-07-CCP, which provided information regarding radon toxicity and free testing. Also provided to the Licensee was the “Heart and Nutrition” newsletter. Licensee and LPA reviewed these issues. LPA and Licensee discussed California Megan's Law. LPA provided the website: www.meganslaw.ca.gov. The Licensee was advised of their responsibility to be current on all regulatory changes by viewing the Community Care Licensing webpage at www.ccld.ca.gov. LPA advised the Licensee of the Child Care Advocate Program.

The provider was reminded of the following: report suspected child abuse and neglect, maintain children’s records according to regulation, post all required forms, ensure that all adults living or working in the home have criminal background clearances to avoid civil penalties associated with this requirement; corporal punishment, smoking, exersaucers, bouncy seats, walkers, and jumpers are not allowed in day care.

The 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 Community Care Licensing. 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 provided the Licensee with the Notice of Site Visit – LIC 9213. The Licensee posted this notice in LPA’s presence.

Based on today's visit, a deficiency was observed and described on the LIC 809D. An exit interview was conducted with the Licensee, who was provided a copy of their Appeal Rights (LIC 9058 1/16). Their signature on this form acknowledges receipt of these rights.

SUPERVISOR'S NAME: Tulam Vu	TELEPHONE: (619) 767-2205
LICENSING EVALUATOR NAME: JoAnn R Legaspi	TELEPHONE: (619) 767-2239
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

LIC809 (FAS) - (06/04)

Page: 2 of 3

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: HAYDER, SAHRA FAMILY CHILD CARE	FACILITY NUMBER: 376623856
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 07/19/2019

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 07/26/2019 Section Cited HSC 1596.866(2)(A)(B)	1 2 3 4 5 6 7	Additional health and safety training; condition of licensure – “… each family day care home licensee who provides care, shall have … training … shall include … Pediatric first aid … Pediatric cardiopulmonary resuscitation (CPR).” This requirement is not met as	1 2 3 4 5 6 7	The Licensee is already scheduled to complete a current First Aide/CPR training on 07/20/2019. The Licensee agrees to provide LPA with a copy of the current/unexpired First Aide/CPR card no later than 07/26/2019.
	8 9 10 11 12 13 14	evidenced by: the Licensee’s First Aide/CPR card expired on 01/22/2019. Based on LPA’s observation, the Licensee failed to ensure current First Aide/CPR training was current, which poses as a potential risk to children in care.	8 9 10 11 12 13 14
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME: Tulam Vu	TELEPHONE: (619) 767-2205
LICENSING EVALUATOR NAME: JoAnn R Legaspi	TELEPHONE: (619) 767-2239
LICENSING EVALUATOR SIGNATURE:	DATE: 07/19/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/19/2019

LIC809 (FAS) - (06/04)

Page: 3 of 3