376100952-12-18-2023-51-CC-ALMA-CYMS5Y-20231218123506

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 376100952
Report Date: 12/18/2023
Date Signed: 12/18/2023 12:35:11 PM

Document Has Been Signed on 12/18/2023 12:35 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:	HAMASAED, AVAN FAMILY CHILD CARE		FACILITY NUMBER:	376100952
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 8	CENSUS: 1	DATE:	12/18/2023
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME BEGAN:	11:35 AM
MET WITH:	Avan Hamasaed		TIME COMPLETED:	12:50 PM

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On 12/18/23 at 11:35 AM Licensing Program Analyst (LPA) Adrian Mangina conducted a Case Management/Increase in capacity inspection of home with Licensee Avan Hamasaed. The purpose of the visit is to ensure that the home is in compliance with standards established in CCR, Title 22, Division 12, Chapter 3. Also in the home was Licensee's husband and Assistant Bektiar Hamasaed and one child in care. Proper ratios and supervision was observed. The 4-bedroom, 2-bathroom single story home was toured and inspected to ensure an environment safe for the care and supervision of children. Licensee owns home and has provided copy tax bill as proof of control of property.

Applicant will be using the following rooms for childcare: kitchen, living room, hallway, dining room, daycare room, daycare bathroom, and fenced back yard. The following areas will be off limits: all bedroooms, master bathroom, and attached garage. The off-limit areas either have safety latches, locks, doorknob covers or gates to prevent access. There are no bodies of water on the property. The applicant has sufficient toys and equipment available. Outdoor play area is the fenced back yard.

The 2A10BC fire extinguisher located in the kitchen and the combination smoke detector/carbon monoxide detector located in hallway meet requirements and are operational. Licensee was reminded to ensure that all chemicals are stored in inaccessible areas of the home.

Licensee's First Aid and CPR expire on 11/2025 and Mandated Reporter Training AB 1207 was waived due to language. Assistant's CPR expires 12/2025 and Mandated Reporter Training AB 1207 was waived due to language. Licensee and Staff meet immunization requirements per SB792. Licensee states that there are no weapons in the home. LPA reviewed one child file which was complete. Licensee had current roster of children. All required documents were posted. Last Disaster drill was conducted 11/15/23.

continued on LIC809.

SUPERVISORS NAME: Renesha Askew
LICENSING EVALUATOR NAME: Adrian L Mangina
LICENSING EVALUATOR SIGNATURE:	DATE: 12/18/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/18/2023

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
CCLD Regional Office, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108

FACILITY NAME: HAMASAED, AVAN FAMILY CHILD CARE	FACILITY NUMBER: 376100952
	VISIT DATE: 12/18/2023

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LIC809 page 2

Licensee was reminded that all adults 18 and over living in the home, persons who provide care and supervision to children, and staff who have contact with children, 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.

The new provider packet was reviewed with the applicant including information on ratios and capacity, child abuse reporting, children’s records, immunizations, adults living or working in the home, car seat law, shaken baby syndrome, SIDS, safe sleep practices, effects of lead poisoning, and the YMCA Resource Center. Licensee was reminded that corporal punishment, smoking, walkers, exersaucers, jumpers, and bouncy seats 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 reviewed with applicant the LIC 311D, Forms/Records to Keep In Your Family Child Care Homes, children’s forms/records, facility forms/records, and information to be posted. Entrance

LPA discussed the safe sleep regulations with applicant and discussed the Child Care Licensing Safe Sleep webpage at: https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/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.

On this date, 12/18/23, the California Attorney General - Megan’s Law website was searched for information on sex offenders required to register with local law enforcement under California's Megan's Law. No registered sex offenders were found at the facility addresses. Under state law, some registered sex offenders are not subject to public disclosure; therefore, they may not have been included in this search. However, the Department conducts a monthly cross reference of each address on record for all registered sex offenders against all CCLD facility addresses pursuant to information shared by California DOJ.

Continued on LIC809 page 3

SUPERVISORS NAME: Renesha Askew
LICENSING EVALUATOR NAME: Adrian L Mangina
LICENSING EVALUATOR SIGNATURE:	DATE: 12/18/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/18/2023

LIC809 (FAS) - (06/04)

Page: 2 of 3

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: HAMASAED, AVAN FAMILY CHILD CARE	FACILITY NUMBER: 376100952
	VISIT DATE: 12/18/2023

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LIC809 page 3

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) or (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.

Applicant was informed of the MyChildCarePlan.org site, 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.

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platforms. To receive important licensed related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-carelicensing/subscribe and select the Child Care option to receive email communication.

LPA discussed and provided applicant with the following information:

· Child Care Advocates - email address childcareadvocatesprogram@dss.ca.gov.

· For common questions or questions regarding licensing requirements to contact the Child Care Licensing duty line at 619-767-2248.

Licensee is in substantial compliance with title 22 regulations. No corrections are needed. A large license for 14 children children may be granted upon final file review.

Exit interview conducted and report was reviewed with the licensee, Avan Hamasaed. A notice of site visit was given to Licensee and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days.

SUPERVISORS NAME: Renesha Askew
LICENSING EVALUATOR NAME: Adrian L Mangina
LICENSING EVALUATOR SIGNATURE:	DATE: 12/18/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/18/2023

LIC809 (FAS) - (06/04)

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