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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376101240
Report Date: 02/21/2023
Date Signed: 02/21/2023 11:30:45 AM

Document Has Been Signed on 02/21/2023 11:30 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:YOUNAN, KHLOUD FAMILY CHILD CAREFACILITY NUMBER:
376101240
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 1DATE:
02/21/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
10:40 AM
MET WITH:Licensee Khloud YounanTIME COMPLETED:
11:40 AM
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On 2/21/2023 @ 10:45 a.m., Licensing Program Analyst (LPA) Joelle Redding, made an unannounced visit for the purpose of an increase in capacity. Application was received on 12/15/22. Fire clearance was granted on 2/9/2023.

Licensee was out of the home running errands. LPA spoke with her husband, Sarmad, via Google Translate. Licensee returned to the home shortly thereafter and LPA used Language Link to complete the visit (Mohammed #15989). There was one child in care, Sarmad's grandniece. LPA checked the pool gate to ensure it is in working order. All exit signs were in place. Fire extinguisher was mounted, smoke alarm and carbon are operational. All required forms were posted. The home was clean and orderly, with appropriate toys, games and books for children. Licensee was reminded that there is no smoking in or around day care hours when children are present.

A capacity handout for a large family homes was reviewed and provided. Licensee understands that she may not operate as a large family home (no more than 12 children or 14 if two are school age and no more than three children under 24 months) unless there is an assistant present. If there is no assistant present, she may only operate as a small family home with a capacity of 6, or 8 if there are no more than two children under the age of 24 months and two are school age)

The increase in capacity is granted and a new license will be sent for posting.
SUPERVISORS NAME: Renesha Askew
LICENSING EVALUATOR NAME: Joelle Redding
LICENSING EVALUATOR SIGNATURE: DATE: 02/21/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/21/2023
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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