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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376628601
Report Date: 04/30/2020
Date Signed: 04/30/2020 10:05:03 AM

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:FARAH, ASHO FAMILY CHILD CAREFACILITY NUMBER:
376628601
ADMINISTRATOR:ASHO FARAHFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(619) 642-6455
CITY:SAN DIEGOSTATE: CAZIP CODE:
92105
CAPACITY:14CENSUS: 0DATE:
04/30/2020
TYPE OF VISIT:OfficeANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH:Asho FarahTIME COMPLETED:
10:00 AM
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Licensing Program Analyst (LPA) Jo Ann Legaspi conducted an office meeting with Applicant Asho Farah to review her application packet.

The Applicant originally applied for a relocation with a large license. Due to the COVID 19 Stay At Home orders, the fire inspector is unable to currently conduct fire inspections. The Applicant submitted an application packet for a small licensed; upon licensure, the Applicant's secondary application for the capacity increase will be processed in the event the fire inspector is released to conduct fire inspections.

The Applicant and LPA reviewed the pre licensing information packet as preparation for the future tele pre-licensing visit.

An exit interview was conducted with Applicant Farah. Applicant Rights (LIC 9098 01/16) along with a copy of this report was provided to the Applicant and their signature on this form confirms receipt of these rights.


SUPERVISOR'S NAME: Tulam VuTELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: JoAnn R LegaspiTELEPHONE: (619) 767-2239
LICENSING EVALUATOR SIGNATURE:

DATE: 04/30/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/30/2020
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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