<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434410667
Report Date: 11/15/2019
Date Signed: 11/15/2019 12:13:11 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME:HAMEED, NAILAFACILITY NUMBER:
434410667
ADMINISTRATOR:HAMEED, NAILA & ABDULFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(408) 504-2270
CITY:SAN JOSESTATE: CAZIP CODE:
95135
CAPACITY:14CENSUS: 2DATE:
11/15/2019
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
11:45 AM
MET WITH:Naila HameedTIME COMPLETED:
12:15 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 11/15/19 Licensing Program Analyst (LPA) Monica Mathur conducted an unannounced Plan of Correction (POC) Inspection at Naila Hameed's family day care. Purpose of the inspection was to check the backyard fence for repairs as a result of citation issued during an annual random inspection on 09/25/19. Present in the home was Licensee and 2 day care children (1 infant, 1 preschool age).

LPA observed backyard fence was repaired. Naila submitted photos of the repaired fence prior to inspection. Naila agrees to stay in compliance with the requirements of the regulation. This citation was cleared during today's inspection and a Letter Of Clearance provided to Licensee.

This report was reviewed with Licensee. A NOTICE OF SITE VISIT WAS ISSUED, SHOULD BE POSTED NEAR FRONT ENTRANCE FOR 30 CONSECUTIVE DAYS.
SUPERVISOR'S NAME: Diana StephensonTELEPHONE: (408) 324-2128
LICENSING EVALUATOR NAME: Monica MathurTELEPHONE: (408) 334-8312
LICENSING EVALUATOR SIGNATURE:

DATE: 11/15/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/15/2019
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
Page: 1 of 1