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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 334842550
Report Date: 06/21/2023
Date Signed: 06/21/2023 04:03:32 PM

Document Has Been Signed on 06/21/2023 04:03 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
INLAND EMPIRE CHILD, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME:ABDRABOH FAMILY CHILD CAREFACILITY NUMBER:
334842550
ADMINISTRATOR:ABDRABOH, RANAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(760) 628-9918
CITY:RIVERSIDESTATE: CAZIP CODE:
92508
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 9DATE:
06/21/2023
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
11:15 AM
MET WITH:Rana AbdrabohTIME COMPLETED:
04:15 PM
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On 06/21/23 at 11:15 AM Licensing Program Analysts (LPAs) Raymond Moorehead and Blanca Ruiz arrived at the facility to conduct a Case Management inspection for the purpose of addressing separate matter that was discovered during an inspection. LPAs met with licensee, Rana Abdraboh and licensee's assistants Abidalrahman, Amanda Abdraboh and one other assistant. LPAs conducted a tour of the facility and census was taken. Upon arrival to the facility, 9 children were observed, 3 of them were infants. Some children were playing in their playpens, others were napping in the living room area and/or having a snacks.
Prior inspections were conducted on 05/09/23 and 05/24/23, during these inspections, licensee confirmed that she allowed family members to live at the facility without clearance. Licensee is aware of Title 22 Section 102370 Criminal Record Clearance. LPAs provided information to the licensee to resolve the issue during the prior inspection. LPAs followed up with the licensee on 05/30/23 regarding the pending associations, but no action has been taken to resolve the issue since licensee stated that they are no longer living at the facility.

On 05/24/23 Licensee informed LPAs that an outside agency visited the facility on 05/10/23 and conducted an interview with a child. In addition, LPAs observed a backyard inaccessible to children in care on 05/24/23 due to a construction project to replace wooden fence with a brick wall around the backyard. Multiple construction workers were observed on site. The project ended on 06/09/23. Licensee denied being aware of reporting incidents to Community Care Licensing (CCL). Licensee failed to report an unusual incident that occurred at the facility that jeopardized the health and safety of the children in care. Licensee was reminded to be in close communication with Community Care Licensing (CCL) to address any questions, concerns and/or to verify substantial compliance. Lastly, licensee was advised to contact the Duty Officer available Monday-Friday 8:00 a.m. to 5:00 p.m. to obtain clarification if needed at (951)782-4200.


Please See LIC809-D for cited deficiencies of the California Code of Regulations, Title 22, Div. 12.
SUPERVISORS NAME: Aaron Ross
LICENSING EVALUATOR NAME: Raymond Moorehead
LICENSING EVALUATOR SIGNATURE: DATE: 06/21/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/21/2023
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
INLAND EMPIRE CHILD, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME: ABDRABOH FAMILY CHILD CARE
FACILITY NUMBER: 334842550
VISIT DATE: 06/21/2023
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LPAs informed licensee Rana Abdraboh that this report dated 06/21/2023 documents 1 Type A citation which shall be posted for 30 consecutive days as there was an immediate risk to the health, safety, or Personal Rights of children in care. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224) was provided to facility during this inspection. The LIC 9224/Type A citation must be provided to parents/guardian of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for the verification.


Exit interview was conducted and report was reviewed with licensee Rana Abdraboh. A Notice of Site Visit was given and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days.

Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
SUPERVISORS NAME: Aaron Ross
LICENSING EVALUATOR NAME: Raymond Moorehead
LICENSING EVALUATOR SIGNATURE:

DATE: 06/21/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/21/2023
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 06/21/2023 04:03 PM - It Cannot Be Edited


Created By: Raymond Moorehead On 06/21/2023 at 01:14 PM
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
, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: ABDRABOH FAMILY CHILD CARE
FACILITY NUMBER: 334842550

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/21/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Request Denied
Type A
06/22/2023
Section Cited
CCR
102370(d)(1)

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All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1596.871 shall prior to working, residing, or volunteering in a licensed facility:
(1) Obtain a California clearance or a criminal record exemption as required by the Department ... as specified in Section 102370(j)
This requirement was not met as evidenced by:
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Licensee agrees to complete the Criminal Record Clearance for the following uncleared adults (family members): Shukri Saleh, Rania Khaleel, Ahed Saleh prior to returning to the home and/or to provide proof of residency from the individuals in question to clarify information.
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Per licensee's own statement the following family members:
Shukri Saleh, Rania Khaleel, Ahed Saleh lived at the license facility without criminal record clearance.
This is an immediate Health and Safety risk to the children in care.
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In addition, licensee is to submit a written statement of understanding of the importance of criminal record clearances for adults before they live or work in the home.


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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:Aaron Ross
LICENSING EVALUATOR NAME:Raymond Moorehead
LICENSING EVALUATOR SIGNATURE:
DATE: 06/21/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/21/2023


LIC809 (FAS) - (06/04)
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Document Has Been Signed on 01/23/2024 03:37 PM - It Cannot Be Edited

Document is an Amendment of Original Document on 12/28/2023 07:01 PM


Created By: Raymond Moorehead On 06/21/2023 at 01:18 PM
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
INLAND EMPIRE CHILD, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: ABDRABOH FAMILY CHILD CARE
FACILITY NUMBER: 334842550

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/21/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Deficiency Dismissed
Type B
06/26/2023
Section Cited
CCR
102416.2(d)(1)

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Amended
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Amended
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Amended

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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:Aaron Ross
LICENSING EVALUATOR NAME:Raymond Moorehead
LICENSING EVALUATOR SIGNATURE:
DATE: 06/21/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/21/2023


LIC809 (FAS) - (06/04)
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