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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 015700227
Report Date: 04/19/2022
Date Signed: 04/19/2022 04:04:01 PM

Document Has Been Signed on 04/19/2022 04:04 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
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME:ELDEEB, SAHARFACILITY NUMBER:
015700227
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 7DATE:
04/19/2022
TYPE OF VISIT:POCANNOUNCEDTIME BEGAN:
02:50 PM
MET WITH:Sahar EldeebTIME COMPLETED:
04:15 PM
NARRATIVE
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On 04/19/2022 at 10:10AM, Licensing Program Analyst (LPA) Kelly Phan arrived unannounced and met with a fingerprinted and associated staff member. LPA called licensee at 10:56AM and confirmed with licensee that she would not be back until 2 to 3PM for a doctor's visit. Later at 2:50PM, LPA arrived announced and met with licensee Sahar to discuss purpose of visit. The purpose was to conduct a plan of correction (POC) inspection to verify if corrections were made. Present for this inspection was two infants and six preschool children in care. LPA entered the facility and began the inspection of the facility to conduct a health and safety check.

During the inspection LPA observed the following deficiencies:

At 10:26AM, LPA observed and verified with staff member the ages of the children, also to verify if staff member has CPR and First aid training. Staff member states that she has first aid training, but does not have CPR. LPA explains that she is not able to be alone with children if she does not have both training. However, the licensee's adult son and is a helper was present and has CPR and First aid training that was observed by LPA on 4/19/2022 via text message from her adult son.

On 4/6/2022, LPA observed 8 children in care, two who were not at least six years old and were not attending school, therefore a type A deficiency was cited. Based on LPA's observations today, licensee has failed to correct deficiency cited from prior inspection to reduce capacity by two (2) children. A civil penalty of $250.00 and then would drop to $100/day until deficiency is corrected. See LIC 809D

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 $100.00. Appeal Rights were also given and discussed. An exit interview was conducted with licensee Sahar Eldeeb


SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Kelly Phan
LICENSING EVALUATOR SIGNATURE: DATE: 04/19/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/19/2022
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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Document Has Been Signed on 04/19/2022 04:04 PM - It Cannot Be Edited


Created By: Kelly Phan On 04/19/2022 at 10:43 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: ELDEEB, SAHAR
FACILITY NUMBER: 015700227

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/19/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
04/19/2022
Section Cited
CCR
102416.5(b)(3)

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102416.5 (b)(3) For a Small Family Child Care Home, the maximum number of children for whom care may be provided including children under age 10 who reside at the licensee's home...More than six and up to eight children.
This requirement is not met as evidenced by:
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LPA also was informed by licensee that one of the children is attending part-time from 9:00AM to 1:30PM

Licensee would put one of her own foster children into another family member's care or enroll him into a daycare nearby starting on 4/25/2022.
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Based on observations and interview with staff member, licensee did not comply with the section stated as LPA observed 7 children present today, and verified with staff member that there were no school aged children, which poses an immediate health, safety, or personal right risks to children in care.
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Failure to correct will result in a $100 per day civil penalty until corrected. Repeat violations are $250 per violation and $100 per day until corrected.

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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:Jason Jang
LICENSING EVALUATOR NAME:Kelly Phan
LICENSING EVALUATOR SIGNATURE:
DATE: 04/19/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/19/2022


LIC809 (FAS) - (06/04)
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