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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376101080
Report Date: 11/22/2022
Date Signed: 11/22/2022 10:45:46 AM

Document Has Been Signed on 11/22/2022 10:45 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:YOUSIF, HELDA FAMILY CHILD CAREFACILITY NUMBER:
376101080
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 6CENSUS: 3DATE:
11/22/2022
TYPE OF VISIT:OfficeANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Helda YousifTIME COMPLETED:
10:45 AM
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On 11/22/22 at 10:00AM Licensing Program Manager (LPM), Renesha Askew and Licensing Program Analyst (LPA), Patrick Ma conducted a virtual office meeting with Licensee, Helda Yousif via video conferencing (MS Teams). The purpose of this meeting is to discuss Licensee’s ratio and capacity violation coupled with her request to increase her capacity for 8 to 14 children after said violations were issued.

During Case Management inspection on 10/20/22 the facility was cited the following Type A citations
• 102416.5(d)(1) Staffing Ratio and Capacity: During the month of September and October licensee was over capacity and provided care for 9-10 children at the same time.
• 102417(g)(4) Operation of a Family Child Care Home: Cleaning compounds and medication were accessible under kitchen sink, bathroom sink, and a bedroom which was previously made off-limits.

The Licensee has come into compliance ensuring hazardous items are inaccessible and that she is within ratio and capacity which was verified during a follow-up visit on 11/4/2022. The two citation sections above and FCCH Capacity/Ratio Requirements handout were reviewed with and provided to Licensee.

Licensee was also provided with the CDSS Child Care Licensing (CCL) Family Child Care Providers Resource link with instructional videos: https://ccld.childcarevideos.org/family-child-care-providers/. It is recommended for Licensee to review the video including, but not limited to: “How Many Children Can Attend a Family Child Care Home?” and “Locks and Inaccessibility Requirements in Child Care”. Licensee states she understands that she needs to abide by Health and Safety Code and Title 22 Regulations in the operation of her Family Child Care Home. A Technical Support Program (TSP) referral has been submitted today, 11/22/22, on Licensee’s behalf and a copy of the TSP brochure was provided. For questions related to TSP, email: Childcaretechnicalsupport@dss.ca.gov
(con't)
SUPERVISORS NAME: Renesha Askew
LICENSING EVALUATOR NAME: Patrick Ma
LICENSING EVALUATOR SIGNATURE: DATE: 11/22/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/22/2022
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: YOUSIF, HELDA FAMILY CHILD CARE
FACILITY NUMBER: 376101080
VISIT DATE: 11/22/2022
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(con't)
Licensee was advised to regularly visit the Community Care Licensing WEB SITE: www.ccld.ca.gov for quarterly updates and regulation. A copy of the Fall 2022 Quarterly update was provided. Licensee stated she is signed up to receive Provider Information Notices (PIN's). During meeting licensee was provided the Duty Line: 619-767-2248.

Licensee states she understands that she needs to abide by Health and Safety Code and Title 22 Regulations in the operation of her Family Child Care Home. Licensee will be issued an increase in capacity from 8 to 14 today.

A copy of this report, appeal rights, and above stated documents were emailed to the Licensee at the conclusion of this meeting. The Licensee will confirm receipt of this report via e-mail and the reply of confirmation will serve as the signature acknowledging these rights.
SUPERVISORS NAME: Renesha Askew
LICENSING EVALUATOR NAME: Patrick Ma
LICENSING EVALUATOR SIGNATURE:

DATE: 11/22/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/22/2022
LIC809 (FAS) - (06/04)
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