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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 372016460
Report Date: 10/29/2024
Date Signed: 10/29/2024 12:42:56 PM

Document Has Been Signed on 10/29/2024 12:42 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
SAN DIEGO N. CC RO, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME:ADAME, FATIMA FAMILY CHILD CAREFACILITY NUMBER:
372016460
ADMINISTRATOR/
DIRECTOR:		FATIMA ADAMEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(858) 538-4275
CITY:SAN DIEGOSTATE: CAZIP CODE:
92129
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 6DATE:
10/29/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:26 AM
MET WITH:Fatima Adame TIME VISIT/
INSPECTION COMPLETED:
12:55 PM
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On 10/29/2024 at 10:26 AM Licensing Program Analysts (LPAs) Stefanie Mutialu and Annette Sutherland conducted an unannounced inspection with the Licensee. LPAs identified themself, disclosed the purpose of the inspection and was granted entry into the facility by the Licensee. Present in the home were the Licensee, spouse, and six (6) day care children. The two (2) story home was toured and inspected to ensure an environment safe for the care and supervision of children. Licensee accompanied LPAs inside and out of the facility during this inspection. The fire extinguisher, smoke detector, and carbon monoxide detector meet requirements and are operational. All hazardous items were latched/locked and secured out of reach of children. There are no bodies of water on the property. Licensee states that there are no weapons in the home. A review of staff records on this date indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse clearances or exemptions. First Aid and CPR certifications expire on 09/16/2026. Licensee has required immunizations. Licensee and spouse completed Mandated Reporter Training on 01/09/2024. Children’s and Staff records were reviewed and found to be in order.

Licensee has provided adequate space for the children to eat, sleep and play within the home. Areas used for child care include family room, dining room, living room, nook, kitchen, backyard, and bathroom 1. Off limits areas include the entire second floor, bedroom 1, bedroom 2, bedroom 3,bathroom 2 and bathroom 3, laundry room, and garage and are inaccessible through use of safety gate and door locks. The licensee has sufficient toys and equipment available. The home has a fenced backyard available for outdoor activities.

Provider is hereby reminded of the following: Report suspected child abuse and neglect, maintain children’s records according to regulation, post all required forms, ensure that all adults living or working in the home have criminal background clearances to avoid civil penalties associated with this requirement; corporal punishment, smoking, exersaucers, bouncy seats, walkers, and jumpers are not allowed in day care. Continued on Page 2
SUPERVISORS NAME: Renesha Askew
LICENSING EVALUATOR NAME: Stefanie Mutialu
LICENSING EVALUATOR SIGNATURE: DATE: 10/29/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/29/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 2
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN DIEGO N. CC RO, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME: ADAME, FATIMA FAMILY CHILD CARE
FACILITY NUMBER: 372016460
VISIT DATE: 10/29/2024
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 All equipment that is used should be used only as intended by the manufacturer. Licensee was also provided handouts with information regarding upcoming Safe Sleep Regulations/SIDS, Lead exposure and Shaken Baby Syndrome. LPA and Licensee discussed California Megan's Law and LPA provided: www.meganslaw.ca.gov.

LPA discussed and provided Licensee with the following: child care advocates-email address: childcareadvocatesprogram@dss.ca.gov . In addition, for general questions or questions regarding licensing requirements contact the Child Care Licensing Duty Line at (619) 767-2248.

Incidental Medical services (IMS) policy was discussed. For IMS information see Evaluator Manual – Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm.

No deficiencies cited

An exit interview was conducted with the licensee. The licensee was provided a copy of their appeal rights (LIC 9058 12/15) and their signature on this form acknowledges receipt of these rights.

LPA provided notice of site visit and observed it being posted at the facility.
SUPERVISORS NAME: Renesha Askew
LICENSING EVALUATOR NAME: Stefanie Mutialu
LICENSING EVALUATOR SIGNATURE:

DATE: 10/29/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/29/2024
LIC809 (FAS) - (06/04)
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