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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376100646
Report Date: 05/19/2023
Date Signed: 05/19/2023 02:50:02 PM

Document Has Been Signed on 05/19/2023 02:50 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 NORTH, 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: 8CENSUS: 2DATE:
05/19/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:15 PM
MET WITH:Licensee, Lubna YaqoobTIME COMPLETED:
02:55 PM
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Licensing Program Analyst (LPA), Saraliz Velando conducted a prelicensing inspection for a change of location and change of capacity. LPA met with Licensee, Lubna Yaqoob. Her husband, Ammar Dawood and her minor child was also present. One daycare child was present in care.

LPA toured the home. It is a one level 3 bedroom, 2 bathroom home. Licensee will be using the following areas for day care: Living room, Dining room, Kitchen, Bedroom 1-2, Bathroom 1, and Front Yard. Off-limits areas consist of: Bedroom 3, Bathroom 2, Back Yard, and Garage. There is a fireplace in the living room that has been screened to be inaccessible to children. Licensee has a pool in the off limits Back yard area that meets regulations. Licensee states that there are no weapons or ammunition in the home and LPA did not observe any. The fire extinguisher size (2A10BC) meets requirements and is fully charged and is located by the front door. The smoke detector and carbon monoxide detectors are located in the kitchen area and meet department requirements and are both functional.

Licensee’s Pediatric CPR/First Aid is valid through July 2023. Mandated Reporter Training expired March 2021, but licensee stated she will submit proof within 7 days of this visit. All adults living or working in the home have been fingerprint cleared and associated and immunization requirements have been met. Outdoor play area is fully fenced and equipped with age-appropriate play equipment and toys.
When any IMS is provided, an updated Plan of Operation that includes 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.
SUPERVISORS NAME: Monica Cuddy
LICENSING EVALUATOR NAME: Saraliz Velando
LICENSING EVALUATOR SIGNATURE: DATE: 04/07/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/07/2023
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
SAN DIEGO NORTH, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME: YAQOOB, LUBNA FAMILY CHILD CARE
FACILITY NUMBER: 376100646
VISIT DATE: 05/19/2023
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Licensee is signed up for Quarterly Updates and Provider Information Notices (PINs) for one or more programs on our website: www.ccld.ca.gov.

No deficiencies are cited. Applicant agrees to comply with all regulations and laws governing Family Child Care Homes. A Large license for fourteen (14) will issued upon final review.

Exit interview was conducted and report was reviewed with licensee, Lubna Yaqoob.
SUPERVISORS NAME: Monica Cuddy
LICENSING EVALUATOR NAME: Saraliz Velando
LICENSING EVALUATOR SIGNATURE:

DATE: 05/19/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/19/2023
LIC809 (FAS) - (06/04)
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