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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376101021
Report Date: 07/20/2022
Date Signed: 07/20/2022 03:15:32 PM

Document Has Been Signed on 07/20/2022 03:15 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:SHAHZAD, YASMEEN & HAMIDULLAH FAMILY CHILD CAREFACILITY NUMBER:
376101021
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 5DATE:
07/20/2022
TYPE OF VISIT:Case Management - Licensee InitiatedANNOUNCEDTIME BEGAN:
01:25 PM
MET WITH:Yasmeen Shahzad and Hamidullah ShahzadTIME COMPLETED:
03:25 PM
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On 7/20/22 at 1:25 PM LPAs Saraliz Velando and Adrian Mangina conducted a Case Management/Increase in capacity inspection of home with Yasmeen and Hamidullah Shahzad. The purpose of the visit is to ensure that the home is compliant with standards established in CCR, Title 22, Division 12, Chapter 3. Licensee was in ratio with five (5) minor children of their own.

The three (3) Bedroom two (2) bathroom, one story home, was toured and inspected to ensure a safe and healthful environment for children. The 4A60BC fire extinguisher, smoke detector and carbon monoxide detector are operational. Licensee states that there are no weapons in the home. There are no bodies of water on the premises. Licensee’s CPR and First aid certifications are valid through February 2024 and Mandated reporter training was completed 3/28/24. The following areas are used for the child care: Living room, Kitchen, Dining room and Restroom #1, and Backyard. Off limit areas: Deck, Garage, Bedroom 1, Bedroom 2, Bedroom 3, and Bathroom #2. All poisons, cleaners, and hazardous items are inaccessible to children. Electrical outlets are tamper resistant and window cords are kept out of reach. There are sufficient and appropriate toys and equipment available in the home and backyard for children’s use. Outdoor play area is a fenced backyard. Licensee reminded that visual supervision is required at all times when children are outside.

All adults in the facility have submitted or been cleared for criminal record and child abuse index clearances or exemptions. Licensees were reminded that all adults 18 and over living or working in the home, including employees and volunteers, 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 up to $500.00 maximum per day/per person will be assessed if this regulation is violated.
SUPERVISORS NAME: Monica Cuddy
LICENSING EVALUATOR NAME: Saraliz Velando
LICENSING EVALUATOR SIGNATURE: DATE: 07/20/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/20/2022
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: SHAHZAD, YASMEEN & HAMIDULLAH FAMILY CHILD CARE
FACILITY NUMBER: 376101021
VISIT DATE: 07/20/2022
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Fire clearance was approved on 5/4/22.

Provider is hereby reminded of the following: Report suspected child abuse and neglect, maintain children’s records according to regulation, post all required forms, ensure that all adults living or working in the home have criminal background clearances associated to the facility, 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. LPAs and Licensee discussed California Megan's Law and LPA provided: www.meganslaw.ca.gov. LPAs reviewed Covid-19 guidelines with Licensee and provided Covid-19 resources. LPAs directed Licensee 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.

LPA discussed the safe sleep regulations with licensee [or facility representative] 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 [facility representative] 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.

Per applicant operating hours are from 7:00 AM – 12:00 AM, Monday – Sunday. LPAs reviewed children’s records, helper packet, capacity limitations, supervision, emergency drills. Last drill conducted 5/17/22, child passenger law, unusual incidents reporting, Assembly Bill 633, AB 2084, mandated reporting, SIDS, and Shaken Baby Syndrome. Applicant is reminded that corporal punishment, smoking, walkers, exersaucers, jumpers and bouncy seats shall never be permitted during daycare operation. Licensee was given heat related tips. Licensee reminded that garage is never to be used.
SUPERVISORS NAME: Monica Cuddy
LICENSING EVALUATOR NAME: Saraliz Velando
LICENSING EVALUATOR SIGNATURE:

DATE: 07/20/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/20/2022
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: SHAHZAD, YASMEEN & HAMIDULLAH FAMILY CHILD CARE
FACILITY NUMBER: 376101021
VISIT DATE: 07/20/2022
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The facility is in substantial compliance and no deficiencies are sited at this time. A large license is recommended and may be issued after a thorough file review.

Exit interview conducted and report was reviewed with the licensees Yasmeen and Hamidullah Shahzad. A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
SUPERVISORS NAME: Monica Cuddy
LICENSING EVALUATOR NAME: Saraliz Velando
LICENSING EVALUATOR SIGNATURE:

DATE: 07/20/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/20/2022
LIC809 (FAS) - (06/04)
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