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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304313131
Report Date: 02/17/2022
Date Signed: 02/17/2022 11:47:47 AM

Document Has Been Signed on 02/17/2022 11:47 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, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME:OMER, MAHAMFACILITY NUMBER:
304313131
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: DATE:
02/17/2022
TYPE OF VISIT:OfficeANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Licensee. Ms. Omer, MahamTIME COMPLETED:
12:00 PM
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An Informal Meeting was conducted on this day via Zoom in the Orange Regional Office. Present during the meeting were Regional Manager (RM) Bertha Manzanares, Licensing Program Analyst (LPA) Desai, Ketki and Licensee Omer, Maham.

The purpose of this informal meeting is to discuss the Deficiency cited on 12/07/2021, Licensee was cited for Ratio & Capacity: CCR 1024165 (a) The capacity specified on the license shall be the maximum number of children for whom care may be provided at any one time. Licensee is currently licensed for a Small Family Child Care Home with a capacity of (8) children.



During this inspection, LPA observed 13 children between the ages of 2-5 years of age, along with one assistant.

Licensee submitted a Plan of Correction indicating that she is working with the parents come up with a schedule, so at any time the number of children in care are within the allowed capacity and Offer an alternative schedule of 1 pm to 4 pm, currently children are only present from 8:00 am to 1:00 pm.

At this time the application for a Large Family Child Care home is being withdrawn by the Licensee.

The following was also discussed with the Licensee:


I. The licensee's will be placed on required visits for the next year. The Department will make more frequent
visits for the next year.
2. The licensee was advised that it is her responsibility to know & understand Title 22 Regulations.
3.The licensee's facility must be in compliance at all times.
4. The licensee was advised to check the Child Care Licensing web site at www.cdss.ca.gov/inforesources/community-care-licensing or quarterly updates, training, forms and regulations. Page 1 (continued)
SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Ketki Desai
LICENSING EVALUATOR SIGNATURE: DATE: 02/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/16/2022
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, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME: OMER, MAHAM
FACILITY NUMBER: 304313131
VISIT DATE: 02/17/2022
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5. Licensee shall contact the On-duty worker, who are available Monday to Friday from (8:am to 5:pm) at 714-703-2800 for any inquires or questions.

Copies of E-Learning Video list, Child Ratio’s in Family Child care home were provided.


Exit interview conducted with Administrator, Ms.Omer, Maham who is in agreement with this report which documents this meeting.
SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Ketki Desai
LICENSING EVALUATOR SIGNATURE:

DATE: 02/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/16/2022
LIC809 (FAS) - (06/04)
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