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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343624904
Report Date: 05/04/2023
Date Signed: 05/04/2023 10:25:35 AM

Document Has Been Signed on 05/04/2023 10:25 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: DATE:
05/04/2023
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Bibi Sumaya SalehTIME COMPLETED:
10:40 AM
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At 10:00 a.m. on Thursday, May 4th, 2023, Licensing Program Analyst (LPA) Karyn Guerra met with Licensing Program Analyst (LPA) Karyn Guerra met with Applicant, Bibi Sumaya Saleh, for the purpose of an announced prelicensing inspection. Applicant's Spouse and own children were also present. During today's inspection, LPA observed corrections made to pool fencing. Paneling has been removed as to not obstruct view of pool, and a new latch has been installed. Latch was observed to be within 6 inches from top of fencing and was self latching. Gate was observed to swing away from the pool.

Effective today, Thursday, May 4th, 2023, facility is approved for a Small Family Child Care Home license with a capacity of 6 children with no more than 3 infants, or 4 infants only, or up to 8 children with no more than 2 infants, 1 child in Transitional Kindergarten or above and 1 child at least age 6. Infants are children under the age of 2.
SUPERVISORS NAME: Seychelle De Luca
LICENSING EVALUATOR NAME: Karyn Guerra
LICENSING EVALUATOR SIGNATURE: DATE: 05/04/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/04/2023
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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