376624041-7-24-2023-20-CC-LGAO-CU32F2-20230724172049

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 376624041
Report Date: 07/24/2023
Date Signed: 07/24/2023 05:21:00 PM

Document Has Been Signed on 07/24/2023 05:21 PM - It Cannot Be Edited

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 CARE		FACILITY NUMBER:	376624041
ADMINISTRATOR:	MOHAMED S. & AMBARO A.		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(619) 808-1499
CITY:	SAN DIEGO	STATE: CA	ZIP CODE:	92105
CAPACITY:	14	CENSUS: 6	DATE:	07/24/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	02:00 PM
MET WITH:	Ambaro Aden		TIME COMPLETED:	05:30 PM

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 July 24, 2023, at 2:00PM, Licensing Program Analyst (LPA), Luigi Gargaro, conducted an unannounced annual required inspection and met with co-licensee, Ambaro Aden. LPA disclosed the purpose of the inspection and was granted entry into the facility by the Licensee. Ms. Aden does not speak English but during inspection LPA was able to reach co-licensee Mohamed Said on the phone and he provided translation while analyst conducted visit. When analyst arrived a family of six children and Ms. Aden were present in the facility during this inspection. Analyst was advised that the children were not enrolled in the day care and that Ms. Aden was just watching the children as a favor to a family friend. Though analyst was also advised that the family has come on a few other occasions to be watched for when the parent has gone to run errands. The children were picked up about half an hour into the visit. Five minutes later an enrolled infant did come to the day care and was watched by Ms. Aden. This facility is a one floor, two bedroom, one bathroom apartment. Licensee accompanied LPA inside of the facility during this inspection. The following areas used for child care are: the kitchen, the living room, the first bedroom and the bathroom. Off limits area is the second bedroom which is usually inaccessible through use of a door knob cover which it did not have on today. However, the room door was closed and no children were accessing it. Licensees were reminded, however, that a door knob cover must always remain in place on the door knob to continue to make the room inaccessible to children The fire extinguisher, smoke detector, and carbon monoxide detector met requirements. All hazardous items were inaccessible to children. The storage area for poisons is locked. The licensee has day care equipment available. The licensees take children to a local park for outdoor activities. No bodies of water observed on the premises during the inspection. Licensee stated there are no weapons in the home. 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.

SUPERVISOR'S NAME: Jason Garay	TELEPHONE: (619) 767-2250
LICENSING EVALUATOR NAME: Luigi Gargaro	TELEPHONE: (619) 767-2229
LICENSING EVALUATOR SIGNATURE:	DATE: 07/24/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/24/2023

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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Document Has Been Signed on 07/24/2023 05:21 PM - It Cannot Be Edited

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: 07/24/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

102425(a)(3)

Infant Safe Sleep

(a) There shall be one crib or play yard for each infant who is unable to climb out of the crib or play yard. (3) Mattresses shall be firm and covered with a fitted sheet that is appropriate to the mattress size, fits tightly on the mattress, and overlaps the underside of the mattress so it cannot be dislodged. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on analyst observation, the licensees did not comply with the section cited above as the play yard in the facility did not contain a fitted sheet but, instead, had a blanket that was tied to the underside of the matress which poses/posed a potential health, safety or personal rights risk to children in care.
	POC Due Date: 07/31/2023
	Plan of Correction
1 2 3 4	Licensees state they will by a fitted sheet for the play yard and replace the blanket with it. Licensees will then take a picture of the sheet on the mattress and send it to analyst with a copy of the purchase receipt by 07/31/23 to complete the correction.

Type B

Section Cited

CCR

102425(j)(2)(A)

Infant Safe Sleep

The provider shall supervise infants while they are sleeping and adhere to the following requirements: The provider shall check and document the following: Labored breathing. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on analyst record review, the licensees did not comply with the section cited above in as they have not been keeping safe sleep logs for the one infant they have in care, child #1, which poses/posed a potential health, safety or personal rights risk to children in care.
	POC Due Date: 07/31/2023
	Plan of Correction
1 2 3 4	Licensees stated they were just recently made aware of the safe sleep log and have not been keep a record as required. Analyst provided licensees with a copy of a blank log and licensees state they will keep a log for every infant they enroll going forward. To correct the deficiency, licensees will submit the log to analyst by 07/31/12 for the days from 07/25/23-07/28/23.

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 Garay	TELEPHONE: (619) 767-2250
LICENSING EVALUATOR NAME: Luigi Gargaro	TELEPHONE: (619) 767-2229
LICENSING EVALUATOR SIGNATURE:	DATE: 07/24/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/24/2023

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: SAID, MOHAMED & ADEN, AMBARO FAMILY CHILD CARE	FACILITY NUMBER: 376624041
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 07/24/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

102421(b)

Child's Records

(b) The licensee shall maintain, in each child's record, a copy of the emergency information card as required in Section 102417(g)(7). This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensees did not comply with the section cited above as they did not have any children's files immediately available for analyst to review during his inspection visit for the visiting family of children, or any enrolled children, which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 07/31/2023
	Plan of Correction
1 2 3 4	Licensees state that they have digital copies of files and will complete records for the six children who attend the facility on an occasional basis and also submit a sample of three records of their choosing for enrolled children to analyst by 07/31/23 to complete the correction.

Section Cited

Operation of A Family Child Care Home


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

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 Garay	TELEPHONE: (619) 767-2250
LICENSING EVALUATOR NAME: Luigi Gargaro	TELEPHONE: (619) 767-2229
LICENSING EVALUATOR SIGNATURE:	DATE: 07/24/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/24/2023

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 07/24/2023 05:21 PM - It Cannot Be Edited

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: 07/24/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

102417(g)(8)

Operation of A Family Child Care Home

(8) Each family child care home shall have a current roster of children as specified in Health and Safety Code Section 1596.841. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensees did not comply with the section cited above as they did not have a faciity roster which poses/posed a potential health, safety or personal rights risk to children in care.
	POC Due Date: 07/31/2023
	Plan of Correction
1 2 3 4	Licensees stated they have a digital copy of the roster and will e-mail it to analyst by 07/31/23 to complete the correction. Licensees understand that a roster must be available in some format at all times to have available for an analyst to review during an inspection visit.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

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 Garay	TELEPHONE: (619) 767-2250
LICENSING EVALUATOR NAME: Luigi Gargaro	TELEPHONE: (619) 767-2229
LICENSING EVALUATOR SIGNATURE:	DATE: 07/24/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/24/2023

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: SAID, MOHAMED & ADEN, AMBARO FAMILY CHILD CARE	FACILITY NUMBER: 376624041
	VISIT DATE: 07/24/2023

NARRATIVE

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Licensees' First Aid and CPR certifications were not available for review during today's visit. Licensees have their required immunizations. Co-licensee Said completed his Mandated Reporter Training on 12/21/22 while co-licensee Aden is currently exempt from Mandated Reporter Training. A facility roster was not available for review during today's visit. The last fire and disaster drills were conducted and documented on 12/10/22.

There is one crib or play yard for each infant who is unable to climb out of the crib or play yard. Cribs or play yards are free from all loose articles and objects. The provider does not physically check on sleeping infants every 15 minutes. The licensees are to keep an Individual Infant Sleeping Plan [LIC 9227 (3/20)] for each infant up to 12 months of age. The provider places infants up to 12 months of age on their backs for sleeping.

LPA provided and discussed the following: Report suspected child abuse and neglect, maintain children’s records according to regulation, post all required forms, and ensure that all adults residing or working in the home have criminal background clearances or exemptions. Licensee was reminded that corporal punishment, smoking, exersaucers, bouncy seats, walkers, and jumpers and/or similar equipment are not allowed in daycare. Licensee was also provided handouts with information regarding upcoming Safe Sleep Regulations/SIDS, Lead exposure and Shaken Baby Syndrome. LPA and Licensee discussed California Megan's Law and LPA provided: www.meganslaw.ca.gov.

LPA discussed and provided Licensee with the following: child care advocates email address: childcareadvocatesprogram@dss.ca.gov . In addition, for general questions or questions regarding licensing requirements contact the Child Care Licensing Duty Line at (619) 767-2248. Unusual Incident Reports may be e-mailed to: SDIncidentReports@dss.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.

Four type B violations California Code of Regulations, (Title 22, Division 12 & Chapter 3), are being cited on the attached LIC 809-D.

An exit interview was conducted with licensee Said over the phone and licensee Aden signed the report for the facility. 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: Jason Garay	TELEPHONE: (619) 767-2250
LICENSING EVALUATOR NAME: Luigi Gargaro	TELEPHONE: (619) 767-2229
LICENSING EVALUATOR SIGNATURE:	DATE: 07/24/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/24/2023

LIC809 (FAS) - (06/04)

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