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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376624041
Report Date: 08/13/2019
Date Signed: 08/13/2019 05:52:58 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:SAID, MOHAMED & ADEN, AMBARO FAMILY CHILD CAREFACILITY NUMBER:
376624041
ADMINISTRATOR:MOHAMED SAID & AMBARO ADENFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(619) 808-4200
CITY:SAN DIEGOSTATE: CAZIP CODE:
92105
CAPACITY:14CENSUS: 0DATE:
08/13/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
03:30 PM
MET WITH:Mohamed Said and Ambaro AdenTIME COMPLETED:
04:30 PM
NARRATIVE
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LPA, Luigi Gargaro, conducted an unannounced inspection with the licensees. Analyst met with co-licensee Ambaro Aden when he arrived at the facility. Ms. Aden does not speak English so co-Licensee Mohamed Said was called and came to the facility to meet with analyst. The home was toured and inspected to ensure an environment safe for the care and supervision of children per the standards established in CCR, Title 22, Division 12, Chapter 3, for Family Child Care Homes. The fire extinguisher and carbon monoxide detector meet requirements and are operational. All hazardous items were latched/locked and secured out of reach of children. The licensee was asked whether he had any bodies of water and weapons in the home and he replied no. A review of staff records on this date indicates that all adults or other individuals who require caregiver background checks have received criminal record and child abuse clearances or exemptions. First Aid and CPR certifications expire on 03/18/20 for co-licensee Aden. Co-licensee Said has his copy, issued the same day, at his child care center facility but will send analyst copy and understands a copy must also always remain at his child care home. Children’s records were reviewed.

Licensees have provided adequate space for the children to eat, sleep and play within the home. Areas used for child care include the kitchen, the living room, the first bedroom and the bathroom. Off limits areas include the second bedroom which is inaccessible through use of a door knob cover. The licensee has sufficient day care equipment available. The licensees take children to a local park for outdoor activities. 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 and licensees discussed California Megan's Law and he provided licensees with the website address: www.meganslaw.ca.gov for them to review information regarding their facility on a regular basis.

Licensee was cited two type B violations today (see related 809D citation page). Analyst printed a copy of the Notice Of Site Visit today and had licensee place it in his facility notice area before he left the home.
SUPERVISOR'S NAME: Jason GarayTELEPHONE: (619) 767-2250
LICENSING EVALUATOR NAME: Luigi GargaroTELEPHONE: (619) 767-2229
LICENSING EVALUATOR SIGNATURE:

DATE: 08/13/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/13/2019
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: SAID, MOHAMED & ADEN, AMBARO FAMILY CHILD CARE
FACILITY NUMBER: 376624041
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/13/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
08/16/2019
Section Cited
CCR
102417(g)(1)
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Operation Of A Family Child Care Home. The home shall contain a fire extinguisher and smoke detector device which meet standards established by the State Fire Marshal. This requirement was not met when during today's visit analyst tested two smoke detectors and neither was operating. Not having an operating smoke detector is a potential risk to children in care.
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Licensees have until 08/16/19 within which to replace the batteries for both detectors and then submit a proof of correction form or signed statement attesting to the fact that the correction has been completed and that licensees have operational detectors.
Type B
09/13/2019
Section Cited
HSC
1596.7995(a)(1)
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Immunizations. Commencing September 1, 2016, a person shall not be employed or volunteer at a day care center if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year.
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Licensees have until 09/13/19 within which to obtain proof of immunizations and submit copies to analyst to complete the correction.
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This requirement was not met when licensees did not have proof of required immunizations during today's visit. Not having proof of immunizations upon request is a potential risk to children in care.
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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: Jason GarayTELEPHONE: (619) 767-2250
LICENSING EVALUATOR NAME: Luigi GargaroTELEPHONE: (619) 767-2229
LICENSING EVALUATOR SIGNATURE:

DATE: 08/13/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/13/2019
LIC809 (FAS) - (06/04)
Page: 2 of 2