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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376100800
Report Date: 11/04/2021
Date Signed: 11/04/2021 04:33:24 PM

Document Has Been Signed on 11/04/2021 04:33 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:KHAMMI, GHADA FAMILY CHILD CAREFACILITY NUMBER:
376100800
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
11/04/2021
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
03:25 PM
MET WITH:Applicant, Ghada KhammiTIME COMPLETED:
04:20 PM
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Licensing Program Analyst (LPA), Jennifer Lott, conducted an announced Pre-Licensing Inspection to evaluate corrections made from a previous visit on 10/13/2021. LPA was greeted at the front door by Applicant, Ghada Khammi and granted entry after identifying herself and disclosing the purpose of her visit. Husband, Alaa Maroki provided translating services as applicant's primary language is Arabic.

LPA toured the facility and verified that the following items have been corrected:

Front Pond - The pond has been emptied of all water and has several rocks on the floor of the pond. The Pool Gate has been adjusted and now self latches. The Swing Set has been secured and will no longer fall over. The back yard fence has had additional fencing extended along the bottom to ensure children/animals cannot get underneath it. Front driveway debris has been removed and all tools have been secured in the garage.

Since all corrections have been made, a license for eight (8) children will be granted upon final file review. Applicant agrees to comply with all regulations and laws governing Family Child Care Homes.

An exit interview conducted and report was reviewed with applicant, Ghada Khammi. A notice of site visit was given and must remain posted for 30 days.
SUPERVISORS NAME: Tashima Daniel
LICENSING EVALUATOR NAME: Jennifer Lott
LICENSING EVALUATOR SIGNATURE: DATE: 11/04/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/04/2021
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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