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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 015700391
Report Date: 02/07/2024
Date Signed: 02/07/2024 01:42:08 PM

Document Has Been Signed on 02/07/2024 01:42 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
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME:HUSEIN, LINAFACILITY NUMBER:
015700391
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 4DATE:
02/07/2024
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
12:42 PM
MET WITH:Lina HuseinTIME COMPLETED:
02:21 PM
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Licensing Program Analyst (LPA) Cortez conducted a case management visit for a capacity increase inspection. Present in the home today was the licensee Lina Husein, and 4 children in care (pre school age). All requested documents were received for the increase of capacity application. The fire clearance for a capacity of 14 was received from the Hayward Fire Department

Ratios were discussed including proper ratio compliance in case an assistant is unavailable for a day and or does not come due to illness etc. The Licensee was reminded that whenever an assistant is not present, the licensee will comply with the capacity requirements for a small family child care home.

Licensee operates the facility Monday through Sunday from 7:00am until 5:00pm.

The home consists of 4 bedroom, 3 bathroom, living room/play room area, dining room, kitchen, backyard and garage. The OFF LIMIT AREAS is the 1 master bedroom, 2 bathroom, and part of the kitchen and portion of the backyard/patio. The ON LIMIT AREAS are the living room, family room, 3 bedrooms, 1 bathroom, portion of the backyard and garage . The ISOLATION AREA is the living room area. There are toys and learning materials in the activity room area

.Hazardous materials and toxins are kept out of the reach of children and it was observed that there would be no toxins or hazardous items accessible to children during today's inspection. There is no pool or any type of bodies of water in the home. The home is neat and clean with heating and ventilation for safety and comfort.
The home has one fully charged fire extinguisher (model 2A10BC), and working smoke/carbon monoxide detectors, first aid kit, emergency supplies, and working telephone.

This facility is recommended for capacity increase. Exit interview conducted. Notice of Site was given.
SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Sidney Cortez
LICENSING EVALUATOR SIGNATURE: DATE: 02/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/07/2024
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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