376629254-4-4-2022-20-CC-JARL-CD6PHX-20220404112037

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 376629254
Report Date: 03/30/2022
Date Signed: 04/04/2022 11:20:42 AM

Document Has Been Signed on 04/04/2022 11:20 AM - 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:	ALAWAD, MOHAMED FAMILY CHILD CARE		FACILITY NUMBER:	376629254
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY:	8	CENSUS: 0	DATE:	03/30/2022
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME BEGAN:	07:45 AM
MET WITH:	Mohamed Alawad		TIME COMPLETED:	08:45 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 April 4, 2022 at 07:45 AM, Licensing Program Analyst (LPA), Jo Ann Legaspi conducted an unannounced capacity increase inspection. Licensee Mohamed Alawad was advised of the meeting’s purpose and granted LPA facility entry. Present in the home was the Licensee, his father, and Mazin Alawad (the Licensee's adult brother). Mazin Alwad provided Arabic translation services. On 03/16/2022, Licensee submitted an application (LIC 279) requesting a capacity increase. The Fire Safety Inspection Request (STD 850) was approved by the local fire marshal on 03/30/3022 for fourteen (14) children. This two (2) bedroom, one (1) bathroom single family dwelling was toured and inspected. The off limit area includes the kitchen and one bedroom. The lower kitchen cabinets have cabinet latching locks. The off limit bedroom is made inaccessible by furniture placement. 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 in 01/03/2023. Facility has working 2A10BC fire extinguisher, smoke alarms, carbon monoxide, and the first aid kit in place. The last safety drill was on 04/01/2022. There are no bodies of water on the premises. Per the Licensee, no weapons or ammunition are housed in the facility. The daycare schedule is weekdays 10 AM to 10 PM. The Licensee was provided with the Ratio/Capacity Worksheet for a large family childcare home. The Licensee acknowledged that 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. The Licensee is advised to regularly visit the Community Care Licensing WEB SITE: http://www.ccld.ca.gov/ for quarterly updates and updated regulation information. Duty Line was provided: (619) 767-2248. Southern

SUPERVISOR'S NAME: Tulam Vu	TELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: JoAnn R Legaspi	TELEPHONE: (619) 767-2239
LICENSING EVALUATOR SIGNATURE:	DATE: 04/04/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/04/2022

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: ALAWAD, MOHAMED FAMILY CHILD CARE	FACILITY NUMBER: 376629254
	VISIT DATE: 03/30/2022

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California Child Care Advocate (SCCCA) information was provided. The Licensee is already enrolled in this program’s email email list through the CCLD website, thus receives updated regulation information. Advocate information was provided: (916) 654-1541 and childcareadvocatesprogram@dss.ca.gov

In the areas that were evaluated, no deficiencies were observed. Licensure for a capacity of fourteen (14) of children is approved today (04/04/2022). A new license will be physically retrieved by the Licensee from the licensing office.

A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100. Exit interview conducted and report was reviewed with the Licensee Mohamed Alawad.

SUPERVISOR'S NAME: Tulam Vu	TELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: JoAnn R Legaspi	TELEPHONE: (619) 767-2239
LICENSING EVALUATOR SIGNATURE:	DATE: 04/04/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/04/2022

LIC809 (FAS) - (06/04)

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