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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376100944
Report Date: 12/12/2023
Date Signed: 12/12/2023 04:18:13 PM

Document Has Been Signed on 12/12/2023 04:18 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:MUSSE, ZAHRA FAMILY CHILD CAREFACILITY NUMBER:
376100944
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 3DATE:
12/12/2023
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
03:35 PM
MET WITH:Zahra MusseTIME COMPLETED:
04:30 PM
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On 12/12/23 at 3:35 PM, Licensing Program Analyst (LPA) Keturah Lane conducted an unannounced inspection for a capacity increase with the Licensee. Upon arrival, LPA met with Licensee Zahra Musse and provided the Inspection Checklist (LIC126). The one-story apartment located on lower level was toured and inspected to ensure an environment safe for the care and supervision of children. Present were the Licensee and 3 daycare 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. The apartment complex has a swimming pool that is completely fenced with a self-closing locking gate. Licensee states that sometimes the children use the pool during the summer and parents have given permission. Licensee states that there are no weapons in the home. 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.

Assistant Muktar Farah is fingerprint cleared and associated to the facility. Assistant has current CPR/First Aid, mandated reporter training, required immunizations and negative TB test.

Licensee will be using the following rooms for childcare: living room, dining room, kitchen, bathroom and bedroom 1. The following areas will be off limits: bedroom 2 which includes bathroom 2, and are inaccessible through use of door-knob covers. Licensee provided updated sketch to LPA. There is no garage. There is a working phone at the facility. The Licensee has sufficient age appropriate and safe toys/equipment available. Licensee states she takes the children to a nearby park for outdoor activities and understands visual supervision is required at all times. (continued on LIC809-C...)
SUPERVISORS NAME: Tashima Daniel
LICENSING EVALUATOR NAME: Keturah Lane
LICENSING EVALUATOR SIGNATURE: DATE: 12/12/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/12/2023
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 N. CC RO, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME: MUSSE, ZAHRA FAMILY CHILD CARE
FACILITY NUMBER: 376100944
VISIT DATE: 12/12/2023
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Verification of control of property and landlord notification are on file. Landlord consent (LIC9149) was NOT obtained. The home appears to be large enough to comfortably accommodate 14 children. Licensee understands that without landlord consent (LIC9149) maximum capacity is 12 children. Fire clearance was received on 8/14/23. Licensee and Helper’s First Aid and CPR certifications expire on 8/2025.

Licensee and staff meet immunization requirements and have completed the Mandated Reporter Training which expired 10/22/23. Licensee maintains emergency records for children and had roster available for LPA review. Required documents are posted. LPA reviewed documentation of emergency drills and last drill was conducted on 12/4/23.

Provider is hereby reminded of the following: Report suspected child abuse and neglect, maintain children’s records according to regulation, corporal punishment, smoking, exersaucers, bouncy seats, walkers, and jumpers are not allowed in day care. All equipment that is used should be used only as intended by the manufacturer. LPA and Licensee discussed California Megan's Law and LPA provided: www.meganslaw.ca.gov. LPA Lane directed Licensee to website: https://www.cdss.ca.gov/inforesources/community-care-licensing to receive important updates and information.

Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated. (continued on LIC809-C...)
SUPERVISORS NAME: Tashima Daniel
LICENSING EVALUATOR NAME: Keturah Lane
LICENSING EVALUATOR SIGNATURE:

DATE: 12/12/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/12/2023
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 N. CC RO, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME: MUSSE, ZAHRA FAMILY CHILD CARE
FACILITY NUMBER: 376100944
VISIT DATE: 12/12/2023
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LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed licensee of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. 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: https://www.ada.gov/resources/child-care-centers/.

No deficiencies are cited.



No corrections are needed; a license for 14 may be issued upon final file review. Licensee understands that landlord consent (LIC9149) is required in order to care for more than 12 children. Licensee agreed to comply with all regulations and laws governing family child-care homes.

Exit interview conducted and report was reviewed with the licensee Zahra Musse. Notice of Site Visit was provided and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
SUPERVISORS NAME: Tashima Daniel
LICENSING EVALUATOR NAME: Keturah Lane
LICENSING EVALUATOR SIGNATURE:

DATE: 12/12/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/12/2023
LIC809 (FAS) - (06/04)
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