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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376626783
Report Date: 03/12/2024
Date Signed: 03/12/2024 04:18:11 PM


Document Has Been Signed on 03/12/2024 04:18 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 N. CC RO, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108



FACILITY NAME:KHAMMI, INAS FAMILY CHILD CAREFACILITY NUMBER:
376626783
ADMINISTRATOR:INAS KHAMMIFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(619) 768-3837
CITY:EL CAJONSTATE: CAZIP CODE:
92021
CAPACITY:14CENSUS: 1DATE:
03/12/2024
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME BEGAN:
11:55 AM
MET WITH:Inas KhammiTIME COMPLETED:
04:40 PM
NARRATIVE
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On 3/12/24 at 11:55 AM Licensing Program Analyst (LPA) Gerald Poindexter conducted an unannounced annual inspection. Upon arrival, LPA met with licensee Inas Khammi. Present were the Licensee and one day care child. Also, present via telephone was the licensee’s husband, Waad Gorges, who provided translation from Chaldean to English. The licensee was provided with the Inspection Checklist (LIC 126). The 3-bedroom, 2 bath, one-story home was toured and inspected to ensure an environment safe for the care and supervision of children. Hours of operation are from 7 am to 10pm, Monday through Friday.

The licensee has provided adequate space for the children to eat, sleep and play within the home. Areas used for childcare include the kitchen, living room, dining room, bedroom 1, bathroom 1, and backyard and front yard. Off limits areas include bedroom 2, bedroom 3 and bathroom 2 and are inaccessible through use of door knob covers. The licensee has sufficient toys and equipment available. The home has a backyard that is currently in a state of construction (and ADU is being built). The front yard area used for outdoor activities has white picket fence in a state of disrepair. The licensee says she understands that visual supervision is always required during outdoor activities. 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 a screened fireplace. Poisons, cleaning compounds, medications and other hazardous items are inaccessible to children via latches/locks, except in two and back yard. Adequate heating and ventilation are provided, and heat vent is close to the ceiling. There is a working telephone and email address. Licensee stated there are NO firearms and weapons in the home.

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SUPERVISOR'S NAME: Joelle ReddingTELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Gerald PoindexterTELEPHONE: 619-767-2201
LICENSING EVALUATOR SIGNATURE:
DATE: 03/12/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/12/2024
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
SAN DIEGO N. CC RO, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME: KHAMMI, INAS FAMILY CHILD CARE
FACILITY NUMBER: 376626783
VISIT DATE: 03/12/2024
NARRATIVE
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LPA observed all required postings were posted. Children’s and Staff records were reviewed. Licensee has the required immunizations per SB792. Licensee’s Pediatric CPR/First Aid is current with an expiration date of 4/3/24. Preventative health practices course was completed, which includes lead poison prevention training. Licensee is exempt from Mandated Reporter Training as their primary language is Chaldean.

Emergency drills are conducted and documented with the last one being on 1/5/24. 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 Mary Medina 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: Joelle ReddingTELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Gerald PoindexterTELEPHONE: 619-767-2201
LICENSING EVALUATOR SIGNATURE:

DATE: 03/12/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/12/2024
LIC809 (FAS) - (06/04)
Page: 2 of 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN DIEGO N. CC RO, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME: KHAMMI, INAS FAMILY CHILD CARE
FACILITY NUMBER: 376626783
VISIT DATE: 03/12/2024
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 deficiencies cited.



Exit interview conducted and report was reviewed with the licensee Inas Khammi. During the exit interview, the licensee Inas Khammi, 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: Joelle ReddingTELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Gerald PoindexterTELEPHONE: 619-767-2201
LICENSING EVALUATOR SIGNATURE:

DATE: 03/12/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/12/2024
LIC809 (FAS) - (06/04)
Page: 3 of 5
Document Has Been Signed on 03/12/2024 04:18 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 N. CC RO, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108


FACILITY NAME: KHAMMI, INAS FAMILY CHILD CARE
FACILITY NUMBER: 376626783

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/12/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102417(g)(4)
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: (4) Poisons, detergents, cleaning compounds, medicines, firearms and other items which could pose a danger if readily available to children shall be stored where they are inaccessible to children.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation and interview, the licensee did not comply with the section cited above. LPA observed partially full containers of lighter fluid and sealed cases of diesel exhaust fluid on the wraparound porch where children have limited access. This poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 03/15/2024
Plan of Correction
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Ms. Khammi stated that she will temporarily make the wraparound porch areas off limits and remove all toxic items and place or otherwise make inaccessible to children by 3/15/24.
Type B
Section Cited
CCR
102417(g)(6)
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: (6) Outdoor play areas shall be either fenced, or outdoor play areas shall be supervised by the licensee Section 102417(g)(5).

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation and interview, the licensee did not comply with the section cited above. LPA observed that the on-limits, front yard fencing is damaged and in a significant state of disrepair. This poses a potential health, safety or personal rights risk to persons in care
POC Due Date: 03/15/2024
Plan of Correction
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Ms. Khammi stated that she will temporarily make the front yard off limits until the fencing is repaired. Licensee will photograph the repaired fence and email to LPA by 3/15/24.
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: Joelle ReddingTELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Gerald PoindexterTELEPHONE: 619-767-2201
LICENSING EVALUATOR SIGNATURE:
DATE: 03/12/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/12/2024
LIC809 (FAS) - (06/04)
Page: 4 of 5


Document Has Been Signed on 03/12/2024 04:18 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 N. CC RO, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108


FACILITY NAME: KHAMMI, INAS FAMILY CHILD CARE
FACILITY NUMBER: 376626783

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/12/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102416.3(a)(6)
Alterations to Existing Building or Grounds
(a) Prior to making alterations or additions to a family child care home or grounds, the licensee shall notify the Department of the proposed changed, including, but not limited to, the following: (6) Any change from an area of the family child care home previously identified as "off limits" to an area where care and supervision will be provided to children in care.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on LPA observation and licensee statement, the licensee did not inform the Department of construction of an Accessory Dwelling Unit (ADU) in the on-limits, backyard area. This poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 04/02/2024
Plan of Correction
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The licensee states she will make the backyard area off limits and lock doors to prevent access to the construction area. Licensee states that the alternate play space will be the front yard play area when the fencing has been repaired. Licensee will also provide a new LIC999 floor plan sketch for the backyard by the close of business 4/2/24.
Type B
Section Cited
CCR
102425(j)(2)(D)
Infant Safe Sleep
Documentation shall be maintained in the infant’s file and be available to the Department for review. Documentation shall include the following:

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, as she did not possess and maintain the safe sleep log for one of one infant, C2, in care, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 04/02/2024
Plan of Correction
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LPA has provided a copy of the Safe Sleep Log and communicated instructions. The licensee states she will begin the safe sleep log for infant C2 and keep updated as required. Licenseee wil submit logs via email to the LPA no later that 4/2/24.
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: Joelle ReddingTELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Gerald PoindexterTELEPHONE: 619-767-2201
LICENSING EVALUATOR SIGNATURE:
DATE: 03/12/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/12/2024
LIC809 (FAS) - (06/04)
Page: 5 of 5