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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376101080
Report Date: 10/20/2022
Date Signed: 10/20/2022 02:27:26 PM

Document Has Been Signed on 10/20/2022 02:27 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: 8CENSUS: DATE:
10/20/2022
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Helda YousifTIME COMPLETED:
03:00 PM
NARRATIVE
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On 10/20/22 at 11:30am Licensing Program Analyst, Patrick Ma conducted an unannounced Case Management-Licensee initiated inspection for an increase in capacity from eight (8) to fourteen (14) children. LPA was greeted by Licensee, Helda Yousif. Also present was Licensee's own minor child and 3 child care children present, one was an infant.

On 7/29/22, the licensee submitted an application (LIC 279) to request an increase of capacity. The Fire Safety Inspection Request (STD 850) was approved by the local fire marshal and granted the capacity increase to fourteen (14) children on 9/20/22.

The 3 bedroom, 2 bathroom, 1 story home was toured and inspected to ensure an environment safe for the care and supervision of children. Licensee will be using the living room, dining room, first bedroom on the right, hallway bathroom, and backyard for child care. During inspection, Licensee requested the addition of the master bedroom for child care. Master bedroom was free of hazards but connecting master bathroom was accessible to children which contained hazards such as cleaning solutions under the sink that were accessible. Off limit areas are the master bedroom/bath and garage and are inaccessible by use of door locks. Back bedroom to the right is also off limits but the door was open during child care and hazards such as cosmetic products and medicine was accessible in drawers. Back yard is fully fenced with locks at each end of the gate doors. Visual supervision is required at all times during outdoor play.

The fire extinguisher, carbon monoxide detector, and smoke detector meet requirements and are operational. Hazardous items were latched/locked and made out of reach of children during the inspection. There are no bodies of water on the property. Applicant states that there are no weapons in the home. Children’s and Staff records were reviewed and found to be in order. Records indicated Licensee was over capacity M-W from 3:30pm – 5:30pm caring for children C1 – C9 and licensee’s own minor child under 10 during the month of September 2022 and ongoing into October.
SUPERVISORS NAME: Renesha Askew
LICENSING EVALUATOR NAME: Patrick Ma
LICENSING EVALUATOR SIGNATURE: DATE: 10/20/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/20/2022
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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Document Has Been Signed on 10/20/2022 02:27 PM - It Cannot Be Edited


Created By: Patrick Ma On 10/20/2022 at 01:14 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108

FACILITY NAME: YOUSIF, HELDA FAMILY CHILD CARE

FACILITY NUMBER: 376101080

DEFICIENCY INFORMATION FOR THIS PAGE:

VISIT DATE: 10/20/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
10/20/2022
Section Cited
CCR
102416.5(d)(1)

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Staffing Ratio and Capacity-102416.5(b)(3): For a Small Family Child Care Home, the maximum number of children for whom care may be provided at any one time, including children under age 10 who reside at the licensee's home, shall be...More than six and up to eight children This requirement was not met as evidenced by:
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Licensee will submit updated roster that identifies children removed from enrollment and names and schedule of children remaining. Licensee stated she will not accept more children than allowed on license. Proof of correction will be submitted by 10/21/22.
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Based on records review and declaration statedment, during the month of September and October, Licensee was over capacity and provided care for 9-10 child at the same time which included Licensee's own child under 10. This poses an immediate health and safety risk to children in care.
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Type A
10/20/2022
Section Cited
CCR102417(g)(4)

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102417(g)(4) Operation of a Family Child Care Home: Poisons, detergents, cleaning compounds, medicines, firearms and other items which could pose a danger if readily available to children shall be stored where they are inaccessible to children. This requirement was not met as evidenced by:
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POC was completed during inspection as hazards were lock/latched and made inaccessible to children.
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Based on observation, cleaning compounds under the kitchen sink and master bathroom sink, and medicine in off limit bedroom (door open) was accessible to children which poses an immediate risk to the health and safety of children in care..
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Renesha Askew
LICENSING EVALUATOR NAME:Patrick Ma
LICENSING EVALUATOR SIGNATURE:
DATE: 10/20/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/20/2022


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: YOUSIF, HELDA FAMILY CHILD CARE
FACILITY NUMBER: 376101080
VISIT DATE: 10/20/2022
NARRATIVE
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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.

Licensee was reminded of the staffing/capacity ratios for Large Family Child Care Homes. Twelve (12) children, no more than 4 infants (birth to 24 months) and 8 older children over the age of 2. A qualified assistant (age 14 or older) is required. For fourteen (14) children, no more than 3 infants (birth to 24 months) and 11 older children; at least 2 school age, 1 child at least age 6, 1 child enrolled in and attending kindergarten or elementary school. Landlord consent and written parent notification are required when caring for more than 12 children. When there isn't a qualified assistant, licensee must follow Small Family Home Child Care Regulations.

Master bedroom was approved for child care but the master bathroom will remain locked and inaccessible.
See 809D for deficiencies cited.

LPA Patrick Ma informed licensee Helda Yousif that this report dated 10/20/22 documents 2 Type A citations which shall be posted for 30 consecutive days as there are immediate risks to the health, safety, or personal rights of children in care.

Also, LPA Ma informed the licensee to provide a copy of this licensing report dated 10/20/22 that documents any Type A citations to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

The following corrections are needed for increase capacity:
• Updated roster – over capacity correction

Applicant understands that corrections must be submitted to the Department within 30 days or the application may be denied.
Exit interview conducted and report was reviewed with the applicant Helda Yousif.
SUPERVISORS NAME: Renesha Askew
LICENSING EVALUATOR NAME: Patrick Ma
LICENSING EVALUATOR SIGNATURE:

DATE: 10/20/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/20/2022
LIC809 (FAS) - (06/04)
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