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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376625397
Report Date: 11/01/2022
Date Signed: 11/01/2022 05:22:29 PM


Document Has Been Signed on 11/01/2022 05:22 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, FADUMA FAMILY CHILD CAREFACILITY NUMBER:
376625397
ADMINISTRATOR:FADUMA SAIDFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(619) 703-6015
CITY:SAN DIEGOSTATE: CAZIP CODE:
92105
CAPACITY:14CENSUS: 0DATE:
11/01/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
04:30 PM
MET WITH:Faduma Said and Isho EymoyTIME COMPLETED:
05:30 PM
NARRATIVE
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On 11/01/22 at 4:30PM, Licensing Program Analyst (LPA) Luigi Gargaro conducted an unannounced Case Management visit to the facility today to cite additional deficiencies stemming from an investigation into the licensee's residential status following a 10/03/22 home inspection visit. Present in the home today upon arrival was the licensee's roommate and facility assistant, Isho Eymoy and one child, Ms. Eymoy's nephew. Ms. Said was not present when analyst arrived at the facility but arrived 30 minutes later after she was contacted by roommate Eymoy.

During the course of the previous annual home inspection and follow up investigation, it was determined by analyst that Ms. Said is not residing in the home and has not had control of property for the residence since November of 2021. Ms. Said never advised Licensing that she was no longer the lessee for this property or a listed resident since that date and also falsely testified to analyst that her sole residence currently is at this licensed location.

The following violations of the California Code of Regulations, Title 22; Division 12, were cited: see LIC 809D.

A copy of this report, LIC 809D, appeal rights (LIC 9058), a copy of the license forfeiture letter and LIC 9213 – Notice of Site Visit were provided to the licensee. Licensee was advised to post the LIC 9213 for 30 days. An exit interview was conducted with licensee Faduma Said.
SUPERVISOR'S NAME: Jason GarayTELEPHONE: (619) 767-2250
LICENSING EVALUATOR NAME: Luigi GargaroTELEPHONE: (619) 767-2229
LICENSING EVALUATOR SIGNATURE:
DATE: 11/01/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/01/2022
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 11/01/2022 05:22 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, FADUMA FAMILY CHILD CARE
FACILITY NUMBER: 376625397

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/01/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Deficiency Dismissed
Type A
11/01/2022
Section Cited

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1596.78(a) "Family day care home" means a home that regularly provides care,...and supervision for 14 or fewer children, in the provider's own home, for periods of less than 24 hours per day, while the parents or guardians are away...large family day care home or a small family day care home. This requirement was not met as evidenced by:
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Facility to be closed effective 11/01/21 due to the licensee’s forfeiture of her license as she was reported to have moved from her licensed location on that date. LPA informed Licensee Said the case will be reviewed by the Department's Legal Division for potential administrative action.
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Based on LPA observations, and interviews conducted, Licensee Faduma Said does not reside in the home, where care is being provided, which poses an immediate Health and Safety risk to children in care.
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Deficiency Dismissed
Type A
11/01/2022
Section Cited

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1596.885(c) The department may...revoke any license...issued under this act upon any of the following grounds and in the manner provided in this act:(c) Conduct which is inimical to the health, morals, welfare, or safety of either an individual in or receiving services from the facility or the people of this state. This requirement was not met as evidenced by:
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LPA advised Licensee Said of the importance of not making false statements to the Department. LPA informed Licensee Said that her case will be reviewed by the Department's Legal Division for potential administrative action.
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Based on interviews, Licensee Said engaged in inimical conduct by making false and/or misleading statements to LPA regarding her residence at the facility which poses an immediate Health and Safety 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: 11/01/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/01/2022
LIC809 (FAS) - (06/04)
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