376628999-12-22-2020-20-CC-JARL-BWJN6Z-20201222091158

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 376628999
Report Date: 12/22/2020
Date Signed: 12/22/2020 09:12:36 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:	ABDULAHI, SUAD FAMILY CHILD CARE		FACILITY NUMBER:	376628999
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY:	8	CENSUS: 2	DATE:	12/22/2020
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME BEGAN:	07:45 AM
MET WITH:	Suad Abdulahi		TIME COMPLETED:	08:30 AM

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 December 22, 2020 at 7:45 AM, Licensing Program Analyst (LPA) Jo Ann Legaspi conducted a capacity increase inspection. Due to the COVID 19 outbreak, this inspection was done as a tele visit upon the What’s App platform. The inspection’s purpose is to ensure that the home follows standards established in CCR, Title 22, Division 12, Chapter 3, for Family Child Care Homes. Present in the home was the Applicant, her spouse/assistant and two (2) related children. This two (2) bedroom, one (1) bathroom downstairs apartment unit was toured and inspected. On November 24, 2020, Licensee applied (LIC 279) requesting a capacity increase. The Fire Safety Inspection Request (STD 850) was approved by the local fire marshal on December 15, 2020 for fourteen (14) children. The off limits are the kitchen and one (1) bedroom. The off limit bedroom is made inaccessible to day care children by use of a door safety knob. The kitchen is made inaccessible to children by use of a child safety gate. The following rooms will be used for care: one (1) bedroom, the bathroom, the living room and the dining-room. Licensee accompanied LPA on a tour of the home, as shown on the updated facility sketch. Background criminal record clearances were verified and discussed. First Aid and CPR certifications expire on 10/27/2021. Facility has a working 2A10BC fire extinguisher, smoke alarm, carbon monoxide, and the first aid kit in place. There are no bodies of water on the premises. Per the Licensee, no weapons or ammunition are housed in the facility. The Licensee has more than one year (1) year of prior experience as a regulated small family childcare home operator. The Licensee states they are financially secure to operate a family childcare home for children. The assistant’s regulatory mandatory immunization documentation has been received by the licensing office. Landlord consent is on file.

SUPERVISOR'S NAME: Tulam Vu	TELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: JoAnn R Legaspi	TELEPHONE: (619) 767-2239
LICENSING EVALUATOR SIGNATURE:	DATE: 12/22/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/22/2020

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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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: ABDULAHI, SUAD FAMILY CHILD CARE	FACILITY NUMBER: 376628999
	VISIT DATE: 12/22/2020

NARRATIVE

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A large family day care home may provide care for more than twelve (12) children and up to and including fourteen (14) children, if all of the following conditions are met: at least one child is enrolled in and attending kindergarten or elementary school and a second child is at least six years of age; no more than three (3) infants are cared for during any time when more than twelve (12) children are being cared for; the Licensee notifies a parent that the facility is caring for two additional school age children and that there may be up to thirteen (13) or fourteen (14) children in the home at one time; the Licensee obtains the written consent of the property owner when the family day care home is operated on property that is leased or rented.

The Licensee acknowledges that they may care for more than six and up to eight children, without an additional adult attendant. If no assistant provider is present at a Large Family Child Care Home, then the licensee shall comply with the capacity requirements for a Small Family Child Care Home.

Licensee also acknowledged that the maximum number of children for whom care may be provided at any one time when there is an assistant provider in the home, including children under age 10 who reside at the licensee's home and the assistant provider's children under age 10, shall be either twelve (12) children, no more than four (4) of whom may be infants; or more than twelve (12) and up to fourteen (14) children

Licensure for a capacity of fourteen (14) children is approved. A new license will be generated and mailed to the provider.

LPA will electronically provide the Licensee with the Notice of Site Visit – LIC 9213, which is to be posted for thirty (30) days. An exit interview was conducted. A copy of this report and Licensee/Appeal Rights (LIC 9058) will be e-mailed to the Licensee. The Licensee was advised that acknowledgement of the receipt of the report is to be received within twenty-four hours.

SUPERVISOR'S NAME: Tulam Vu	TELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: JoAnn R Legaspi	TELEPHONE: (619) 767-2239
LICENSING EVALUATOR SIGNATURE:	DATE: 12/22/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/22/2020

LIC809 (FAS) - (06/04)

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