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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376100825
Report Date: 10/15/2021
Date Signed: 10/15/2021 10:19:44 AM

Document Has Been Signed on 10/15/2021 10:19 AM - 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:AWADICH, KATREEN FAMILY CHILD CAREFACILITY NUMBER:
376100825
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 2DATE:
10/15/2021
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Katreen AwadichTIME COMPLETED:
10:25 AM
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On 10/15/21 at 9:00 am Licensing Program Analyst (LPA) Annette Sutherland, conducted an announced Pre-Licensing inspection for relocation with the applicant. Upon arrival, LPA met with applicant Katreen Awadich also present was Imad, Bashar, Faeza. Licensee's child and one day care child was also present. Licensee's husband helped with translation from Arabic. The one-story home was toured and inspected to ensure an environment safe for the care and supervision of children. The fire extinguisher, carbon monoxide detector, and smoke 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 in the home. Applicant states that there are no weapons in the home. CPR and First Aid expire on May 2023. Preventative health practices course was completed on 10/8/17. Lead Poison prevention training was completed on 8/11/21. Mandated reporter training was not completed due to language barrier. 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. Staff immunization requirements were met. Required documents have been posted. Applicant owns the home. The applicant has toys and equipment available.

Applicant will be using the following rooms for childcare: Living room, Dining room, Kitchen, Master bedroom, Master bathroom, Bedroom #1 and #2, Bathroom #1, and Backyard. Off limits areas include Bedroom #3 and garage and are inaccessible through the use of door-knob covers. The home has a fully fenced backyard available for outdoor activities. Front yard is off-limits.

Applicant was reminded of requirements for children’s records, child abuse, and unusual incident reporting, immunizations, adults living or working in the home and associated civil penalties, applicant was also reminded that corporal punishment, smoking, walkers, exersaucers, bouncy seats and jumpers are not allowed in day care.
(continued on LIC809-C...)


SUPERVISORS NAME: Monica Cuddy
LICENSING EVALUATOR NAME: Annette Sutherland
LICENSING EVALUATOR SIGNATURE: DATE: 10/15/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/15/2021
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME: AWADICH, KATREEN FAMILY CHILD CARE
FACILITY NUMBER: 376100825
VISIT DATE: 10/15/2021
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 All equipment that is used should be used only as intended by the manufacturer. LPA provided information regarding Safe Sleep Regulations/SIDS and Shaken Baby Syndrome. LPA and Licensee discussed California Megan's Law and LPA provided: www.meganslaw.ca.gov. LPA Sutherland reviewed COVID-19 guidelines with Applicant and provided COVID-19 resources. LPA Sutherland directed Applicant to website: https://www.cdss.ca.gov/inforesources/community-care-licensing to receive important updates and information.

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 corrections are needed. A license for 8 children may be granted upon final file review. Applicant agreed to comply with all regulations and laws governing family child-care homes.

An exit interview was conducted with applicant. Applicant was provided a copy of their Appeal Rights (LIC9058) along with a copy of the report (LIC809) and their signature on this form acknowledges receipt of these rights.
SUPERVISORS NAME: Monica Cuddy
LICENSING EVALUATOR NAME: Annette Sutherland
LICENSING EVALUATOR SIGNATURE:

DATE: 10/15/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/15/2021
LIC809 (FAS) - (06/04)
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