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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376101080
Report Date: 11/04/2022
Date Signed: 11/04/2022 04:13:42 PM

Document Has Been Signed on 11/04/2022 04:13 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:YOUSIF, HELDA FAMILY CHILD CAREFACILITY NUMBER:
376101080
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 7CENSUS: 3DATE:
11/04/2022
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
03:40 PM
MET WITH:Helda YousifTIME COMPLETED:
04:30 PM
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On 11/4/22 at 3:40pm, Licensing Program Analyst, Patrick Ma conducted an unannounced Case Management-Deficiency inspection for proof of correction. LPA was greeted by Licensee, Helda Yousif. Also present was husband, Wisam Korael and Licensee’s 3 minor children over 10 years of age, and one under 10. There were 2 child care children present, one was an infant. License was operating within ratio and capacity. Regulations 102416.5 on Staffing Ratio and Capacity was provided during the visit.

During the visit, Licensee requested to included Master bathroom in her child care. LPA inspected bathroom, drawers and cabinet were latched and made inaccessible to children. LPA reminded Licensee that all hazards including cosmetic products must remain inaccessible during child care.

No deficiencies cited. Deficiency cited on 10/20/22 is cleared.

Exit interview conducted and report was reviewed with the licensee Helda Yousif. A notice of site visit was given and must remain posted for 30 days.
SUPERVISORS NAME: Renesha Askew
LICENSING EVALUATOR NAME: Patrick Ma
LICENSING EVALUATOR SIGNATURE: DATE: 11/04/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/04/2022
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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