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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343624904
Report Date: 05/03/2023
Date Signed: 05/03/2023 10:59:15 AM

Document Has Been Signed on 05/03/2023 10:59 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, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833
FACILITY NAME:SALEH, BIBI SUMAYAFACILITY NUMBER:
343624904
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 3DATE:
05/03/2023
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
10:05 AM
MET WITH:Bibi Sumaya SalehTIME COMPLETED:
11:05 AM
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At 10:05 a.m. on Wednesday, May 3rd, 2023, Licensing Program Analyst met with Applicant, Bibi Sumaya Saleh, for the purpose of an announced prelicensing inspection. Applicant's spouse and children were also present during inspection. Language Link interpreter services were used in Applicant's preferred language of Dari. During today's inspection, LPA observed gate blocking access to stairs. LPA also observed pool fencing corrections. Pool gate swings away from the pool and is self closing. Latch to the gate, however, was not within 6 inches of the top of the gate. Gate paneling was also added that obstructed the view of the pool. LPA discussed that pool fencing shall not obstruct view of pool and latch needs to be placed within 6 inches from the top of the gate. LPA and Licensee's spouse reviewed alternate latching device. Current latching device requires a key to open.

The following corrections shall be made prior to licensure:

1. Latch on pool gate shall be moved higher so that it is not more than 6 inches from the top of the gate.

2. Paneling shall be removed so the fencing does not obstruct the view of the pool.
SUPERVISORS NAME: Seychelle De Luca
LICENSING EVALUATOR NAME: Karyn Guerra
LICENSING EVALUATOR SIGNATURE: DATE: 05/03/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/03/2023
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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