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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376100800
Report Date: 11/13/2023
Date Signed: 11/13/2023 01:19:56 PM


COMPREHENSIVE INSPECTION

Document Has Been Signed on 11/13/2023 01:19 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:KHAMMI, GHADA FAMILY CHILD CAREFACILITY NUMBER:
376100800
ADMINISTRATOR:GHADA KHAMMIFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(619) 808-6562
CITY:EL CAJONSTATE: CAZIP CODE:
92021
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: DATE:
11/13/2023
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME BEGAN:
11:45 AM
MET WITH:TIME COMPLETED:
11:50 AM
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LPA Poindexter attempted a three-year inspection at this licensee's home. LPA rang doorbell three times and knocked twice -- no answer. There was no apparent activity inside or around the home. LPA left his business card inside the front door closure. LPA also phoned the licensee at 11:52 am and left a voice mail message.
SUPERVISORS NAME: Joelle Redding
LICENSING EVALUATOR NAME: Gerald Poindexter
LICENSING EVALUATOR SIGNATURE: DATE: 11/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/13/2023
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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