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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376624483
Report Date: 08/16/2023
Date Signed: 08/16/2023 02:50:24 PM


Document Has Been Signed on 08/16/2023 02:50 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
SAN DIEGO NORTH, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108



FACILITY NAME:AHMED, MUHUBO FAMILY CHILD CAREFACILITY NUMBER:
376624483
ADMINISTRATOR:MUHUBO AHMEDFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(619) 376-5088
CITY:SAN DIEGOSTATE: CAZIP CODE:
92111
CAPACITY:14CENSUS: 2DATE:
08/16/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:15 PM
MET WITH:Muhubo Ahmed TIME COMPLETED:
03:00 PM
NARRATIVE
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On 8/16/23 at 12:15 pm Licensing Program Analyst (LPA) Gerald Poindexter conducted an unannounced annual inspection. Upon arrival, LPA met with Licensee Muhubo Ahmed. Also, in the home was adult daughters Samira Dahir and Rahmo Dahir (who provided translation from Somali), and husband Osman Handulle. There were two day care children in care, with none under 24 months. Licensee states they typically arrive at 11 am. Licensee was provided the Inspection Checklist (LIC 126). The four-bedroom, two-bathroom, one-story home was toured and inspected to ensure an environment safe for the care and supervision of children.


Licensee has provided adequate space for the children to eat, sleep and play within the home. Areas Licensee stated she uses for childcare include living/family room, kitchen/dining room, bathroom and backyard. Off limits areas include garage, three bedrooms, and master bed/bath, which are made inaccessible through use of door knob covers. There are no stairs in the home. The facility has sufficient toys and equipment available.

The home has a fenced backyard available for outdoor activities and license understands that direct visual observation must be maintained at all times during outdoor play. No body of water was observed during time of inspection.

There is a fully charged fire extinguisher, smoke and carbon monoxide detector that meet requirements and are operational. There is no fireplace. Poisons, cleaning compounds, medications and other hazardous items are inaccessible to children via drawer and cabinet latches. Adequate heating and ventilation are provided. There is a working telephone. Licensee stated there are NO firearms and weapons in the home.

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SUPERVISOR'S NAME: Renesha AskewTELEPHONE: (619) 767-2155
LICENSING EVALUATOR NAME: Gerald PoindexterTELEPHONE: 619-767-2201
LICENSING EVALUATOR SIGNATURE:
DATE: 08/16/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/16/2023
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 4


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN DIEGO NORTH, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME: AHMED, MUHUBO FAMILY CHILD CARE
FACILITY NUMBER: 376624483
VISIT DATE: 08/16/2023
NARRATIVE
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LPA observed all required postings were not posted. Children’s and Staff records were reviewed and found to be in order. Licensee has the required immunizations per SB792. Licensee’s Pediatric CPR/First Aid are current with an expiration date of 7/2024. Licensee is exempt from Mandated Reporter AB1207 training certification due to having limited English proficiency. Licensee’s primary language is Somali.

Emergency drills were not posted. Licensee maintains a current roster of the children which LPA obtained during time of inspection. LPA verified that all adults living or working in the home have been fingerprint cleared and associated. LPA reminded Licensee that all unusual incident reports shall be submitted to Licensing office via email at SDIncidentReports@dss.ca.gov or via fax at (619)767-2203. Duty officer number is (619)767-2248.

Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

LPA conducted child care quality management staff interview with the Licensee. LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep as an additional resource. LPA also informed licensee of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.



Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. 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: https://www.ada.gov/resources/child-care-centers/.

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SUPERVISOR'S NAME: Renesha AskewTELEPHONE: (619) 767-2155
LICENSING EVALUATOR NAME: Gerald PoindexterTELEPHONE: 619-767-2201
LICENSING EVALUATOR SIGNATURE:

DATE: 08/16/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/16/2023
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
SAN DIEGO NORTH, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME: AHMED, MUHUBO FAMILY CHILD CARE
FACILITY NUMBER: 376624483
VISIT DATE: 08/16/2023
NARRATIVE
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Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.


See LIC809D for deficiency cited.

Exit interview conducted and report was reviewed with the licensee. During the exit interview, the Licensee Muhubo Ahmed, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS. A notice of site visit was given and must remain posted for 30 days.

SUPERVISOR'S NAME: Renesha AskewTELEPHONE: (619) 767-2155
LICENSING EVALUATOR NAME: Gerald PoindexterTELEPHONE: 619-767-2201
LICENSING EVALUATOR SIGNATURE:

DATE: 08/16/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/16/2023
LIC809 (FAS) - (06/04)
Page: 3 of 4
Document Has Been Signed on 08/16/2023 02:50 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
SAN DIEGO NORTH, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108


FACILITY NAME: AHMED, MUHUBO FAMILY CHILD CARE
FACILITY NUMBER: 376624483

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/16/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102417(g)(9)(A)
g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (9) Each family child care home shall have a written disaster plan of action prepared on a form approved by the Department. All children, age and ability permitting, and the provider, the assistant provider, and other members of the household, shall be instructed in their duties under the disaster plan. As their age and ability permit, newly enrolled children shall be informed promptly of their duties as required in the plan. (A) Each family child care home shall conduct fire drills and disaster drills at least once every six months.
This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above and did not have dates/times or comments of emergency drills posted, which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 08/30/2023
Plan of Correction
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Licensee states that she will conduct an emergency drill with the children in care and document the date/times, type of drill and details of the drill for LPA review. Licensee will also send image of the Emergency Drill log.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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: Renesha AskewTELEPHONE: (619) 767-2155
LICENSING EVALUATOR NAME: Gerald PoindexterTELEPHONE: 619-767-2201
LICENSING EVALUATOR SIGNATURE:
DATE: 08/16/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/16/2023
LIC809 (FAS) - (06/04)
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