376626049-5-9-2022-20-CC-LGAO-CEA5AT-20220509194740

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 376626049
Report Date: 05/09/2022
Date Signed: 05/09/2022 07:47:56 PM

Document Has Been Signed on 05/09/2022 07:47 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:	SHIRE, HAWEYA & MOHAMED, HAFSA FAMILY CHILD CARE		FACILITY NUMBER:	376626049
ADMINISTRATOR:	H.SHIRE & H.MOHAMED		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(619) 581-4118
CITY:	SAN DIEGO	STATE: CA	ZIP CODE:	92105
CAPACITY:	14	CENSUS: 2	DATE:	05/09/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	03:15 PM
MET WITH:	Haweya Shire and Hafsa Mohamed		TIME COMPLETED:	07:45 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 May 9, 2022, at 3:15PM, Licensing Program Analyst (LPA), Luigi Gargaro, conducted an unannounced annual required inspection and met with the co-licensees, Haweya Shire and Hafsa Mohamed. LPA disclosed the purpose of the inspection and was granted entry into the facility by the Licensees. Ms. Mohamed and two day care children were present when analyst arrived at the facility. After the two children went home with their parent, Ms. Shire came to the facility and a family of five arrived for care shortly thereafter. This facility is a two floor, four bedroom, three bathroom townhouse. Licensees accompanied LPA inside and out of the facility during this inspection. The following areas used for child care are: the kitchen, the dining area, the living room, the first bedroom (primarily as a walk through room for children to access the front patio play area when needed but the room was reviewed today and found to be safely child proofed) and the day care bathroom. Off limits areas are the second main floor bedroom, the second floor, the lower floor level which contains the home garage and the patio off the living room. The second bedroom is made off limits with a door knob cover installed on its door handle. The upper and lower floors are made off limits with installed child safety gates at the staircase entrances. The patio is made off limits with a latching sliding patio door. The fire extinguisher, smoke detector, and carbon monoxide detector met requirements. All hazardous items were inaccessible to children. The licensee has toys, play equipment and materials available. The licensee also has a patio off the first bedroom that is a supplemental outdoor play area for day care children. The patio has a wooden enclosure but as the enclosure does not completely go to the ground licensees understand that any time day care children are using the area, direct supervision must always be provided to ensure their safety and that they remain in the patio. Licensee also takes children to a local park for outdoor activity. The complex has a gated community pool area that is maintained by the complex management and is only accessible with a facility gate key. 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: 05/09/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/09/2022

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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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: SHIRE, HAWEYA & MOHAMED, HAFSA FAMILY CHILD CARE	FACILITY NUMBER: 376626049
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 05/09/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

102417(g)(10)

Operation of A Family Child Care Home

(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (10) A baby walker shall not be allowed on the premises of a family child care home in accordance with Health and Safety Code Sections 1596.846(b) and (c). This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on analyst observation and interview, the licensees did not comply with the section cited above as when anlayst arrived an infant was asleep in a rocker which poses/posed a potential health, safety or personal rights risk to children in care.
	POC Due Date: 05/09/2022
	Plan of Correction
1 2 3 4	The licensee stated that the infant had fallen asleep in the rocker but did have a playpen set up immediately next to the rocker making this a potential risk rather than an immediate one. Parent came to pick up child shortly thereafter. Licensee removed the rocker and understands that it is a prohibited piece of equipment and can not be used in day cares and states will return it to parent. Analyst also provided licensees with a prohibited items flyer for their review.

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 set up play yard did not have a fitted sheet on the mattress but instead had a sleeping mat on top of it which poses/posed a potential health, safety or personal rights risk to children in care.
	POC Due Date: 05/10/2022
	Plan of Correction
1 2 3 4	Licensees understand that all infant mattresses can only use a fitted sheet as part of their napping equipment and no other type of blankets or sheets. Licensee states she will purchase a fitted sheet for the play yard, put it on the mattress and send analyst a photo by 05/10/22 demonstrating that the deficiency has been corrected and the infant is now sleeping only on a fitted sheet mattress.

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: 05/09/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/09/2022

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: SHIRE, HAWEYA & MOHAMED, HAFSA FAMILY CHILD CARE	FACILITY NUMBER: 376626049
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 05/09/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

102425(i)

Infant Safe Sleep

If an infant falls asleep before being placed in a crib or play yard, the provider shall move the infant to a crib or play yard as soon as possible. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, the licensees did not comply with the section cited above as when he arrived child #1 was asleep in a prohibited day care rocker and remained there during the start of the visit when analyst then explained the violation. This poses/posed a potential health, safety or personal rights risk to children in care.
	POC Due Date: 05/09/2022
	Plan of Correction
1 2 3 4	The licensees understand, at this point going forward, they will place an infant who has fallen asleep in any other type of equipment in their own play yard or crib or any other appropriate napping equipment and not leave him to sleep in any other non-appropriate device.

Section Cited

Infant Safe Sleep


	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: 05/09/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/09/2022

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: SHIRE, HAWEYA & MOHAMED, HAFSA FAMILY CHILD CARE	FACILITY NUMBER: 376626049
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 05/09/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Section Cited

Infant Safe Sleep


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

Type B

Section Cited

CCR

102425(j)(2)(B)

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: Signs of distress which includes but is not limited to flushed skin color, increase in body temperature and restlessness. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on analyst interview and record review, the licensees did not comply with the section cited above as they were not familiar with safe sleep regulations and were not documenting napping observations for infants which poses/posed a potential health, safety or personal rights risk to children in care.
	POC Due Date: 05/16/2022
	Plan of Correction
1 2 3 4	Analyst provided licensees with a safe sleep log sample and explained how napping documentation is to be conducted. Licensee states she will maintain napping logs from this point on and to show understanding of the procees will send analyst a sample of the logs for three infants in care for the upcoming week of 05/10/22-05/13/22 to analyst by 05/16/22 to complete the correction.

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: 05/09/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/09/2022

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: SHIRE, HAWEYA & MOHAMED, HAFSA FAMILY CHILD CARE	FACILITY NUMBER: 376626049
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 05/09/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1596.8662(b)(1)

Administration of Child Day Care Licensing

(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on analyst observation and record review, the licensees did not comply with the section cited above co-licensee Mohamed could not find her most recent completed Mandated Reporter Training Certificate which poses/posed a potential health, safety or personal rights risk to children in care.
	POC Due Date: 06/06/2022
	Plan of Correction
1 2 3 4	Ms. Mohamed states she will look for her certificate in her records and will send it to analyst when found but if unable to locate it will take another training and submit a copy of the new certificate to analyst by 06/06/22 to complete the correction.

Type B

Section Cited

CCR

102425(c)

Infant Safe Sleep

An Individual Infant Sleeping Plan [LIC 9227 (3/20)] shall be completed for each infant up to 12 months of age the provider has in care and included in the infant's file at the facility. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on analyst record reviews and interviews, the licensees did not comply with the section cited above as they did not have infant sleeping plans for either infant under 12 months of age which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 05/16/2022
	Plan of Correction
1 2 3 4	Licensee was given a blank copy of the the LIC 9227 and states will have the respective parents fill out the form and send anlayst a copy by 05/16/22 to complete the correction.

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: 05/09/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/09/2022

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: SHIRE, HAWEYA & MOHAMED, HAFSA FAMILY CHILD CARE	FACILITY NUMBER: 376626049
	VISIT DATE: 05/09/2022

NARRATIVE

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First Aid and CPR certifications expire on 02/22/24 for co-license Shire and April of 2023 for co-licensee Mohamed. Licenses have required immunizations. Co-licensee Shire is currently exempt from Mandated Reporter Training. Co-licensee Mohamed could not find her current certification. Facility roster is maintained and was reviewed. The last fire and disaster drills were conducted and documented on 11/17/21. There is not 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 physically checks on sleeping infants every 15 minutes. An Individual Infant Sleeping Plan [LIC 9227 (3/20)] has not been maintained 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.

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.

Seven 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 the licensee. 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: 05/09/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/09/2022

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 05/09/2022 07:47 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: SHIRE, HAWEYA & MOHAMED, HAFSA FAMILY CHILD CARE	FACILITY NUMBER: 376626049
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 05/09/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

102425(a)

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. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on analyst observation and interview, the licensees did not comply with the section cited above as he was advised that an infant who attends in the evening is using the same play yard to sleep in as one who attends in the morning which poses/posed a potential health, safety or personal rights risk to children in care.
	POC Due Date: 05/10/2022
	Plan of Correction
1 2 3 4	Licensees were not aware that play yards could not be shared by different children at different times. Licensee stated that she has a second play yard that she will set up in the day care room so that each infant will have their own napping equipment and will send analyst a photo of the two separate play yards set up for use by 05/10/22 to complete the correction.

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: 05/09/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/09/2022

LIC809 (FAS) - (06/04)

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