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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376100646
Report Date: 07/08/2021
Date Signed: 07/08/2021 04:37:22 PM

Document Has Been Signed on 07/08/2021 04:37 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
CCLD Regional Office, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME:YAQOOB, LUBNA FAMILY CHILD CAREFACILITY NUMBER:
376100646
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
07/08/2021
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
04:00 PM
MET WITH:Lubna YaqoobTIME COMPLETED:
05:00 PM
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On 7/8/21 Licensing Program Analysts Michael Morales-DeSilvestore and Leandra Dolliole conducted an announced prelicensing inspection for the purpose of verifying that the house is set up appropriately for child care.

During the visit LPA's toured the facility. Licensee states she will be using the following areas for child care: Kitchen, Living Room, Bedroom 1 and bathroom 1. The following areas will be off limits: bedroom 2, bedroom 3 and bathroom 2. They will be off limits through the use of door knob covers. The garage will remain off limits and is kept inaccessible with the use of a door knob cover. Facility will use the fenced front yard for outdoor activity. There is a fenced pool in the back yard that will remain off-limits to children in care.

During the inspection the bedrooms were observed to be furnished and the closets had children's clothing in the rooms 1 and 2 and adult clothes in room 3. Children's toys were observed in bedroom 1. The living room was observed to be furnished with couches and a television. The kitchen now contains a stove and kitchen table. Plates and utensils and food were observed in the cabinets. The kitchen contains a large freezer. The garage is also furnished as a second kitchen and contains its own fridge, freezer, and cooking appliances.

No corrections are needed. A license for 8 children will be granted upon final review.
SUPERVISORS NAME: Tashima Daniel
LICENSING EVALUATOR NAME: Michael Morales-DeSilvestore
LICENSING EVALUATOR SIGNATURE: DATE: 07/08/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/08/2021
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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