376101315-12-2-2022-51-CC-TBLK-CLQVHW-20221202152750

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 376101315
Report Date: 12/02/2022
Date Signed: 12/02/2022 03:28:03 PM

Document Has Been Signed on 12/02/2022 03:28 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:	GULED, FARHIYA FAMILY CHILD CARE		FACILITY NUMBER:	376101315
ADMINISTRATOR:	FARHIYA GULED		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(206) 458-2047
CITY:	SAN DIEGO	STATE: CA	ZIP CODE:	92119
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS: 0	DATE:	12/02/2022
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME BEGAN:	01:30 PM
MET WITH:	Farhiya Guled		TIME COMPLETED:	03:45 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	Licensing Program Analyst (LPA), Tyra Block, conducted an announced Pre-Licensing inspection with the licensee, Farhiya Guled for Change of Location. The 2 story,4 bdrm, 3 ba home was toured and inspected to ensure an environment safe for the care and supervision of children. Licensee rents the home and has provided Landlord Notification and proof of control of property. The fire extinguisher (2A10BC), carbon monoxide detector and smoke detector meet requirements and are operational. All poisons, cleaners, and hazardous items were inaccessible and secured out of reach of children, and electrical outlets were covered. There are no bodies of water in the home and the fireplace is screened. Licensee states that there are no weapons in the home. Licensee has certified on their application they have sufficient financial resources to sustain the license. A review of records on this date indicates that all facility staff/ residents or other individuals who require caregiver background checks have received criminal record and child abuse clearances or exemptions. First Aid and CPR expire on 4/2023 and preventative health practices course with lead poisoning prevention is scheduled for 12/6/22. Mandated Reporter Training was not completed, Licensee is exempt due to English not being licensee's primary language. TB clearance and immunization requirements were met. A fire inspection was conducted and clearance received on 11/29/22. Licensee will be using the following rooms for childcare: living room, family room, dining room, kitchen, and hall bathroom. The following areas will be off limits: second floor and all bedrooms. A child safety gate or other barrier is required to barricade the stairs when children under 5 are present. The licensee has sufficient toys and equipment available. The home has a fenced backyard that is currently off-limits but will be made available at a future date. The front yard is available for outdoor activities and licensee understands visual supervision is to be maintained at all times. Advised no changes should be made to the home without prior notice and/or approval from Licensing.

SUPERVISORS NAME: Tashima Daniel
LICENSING EVALUATOR NAME: Tyra Block
LICENSING EVALUATOR SIGNATURE:	DATE: 12/02/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/02/2022

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: GULED, FARHIYA FAMILY CHILD CARE	FACILITY NUMBER: 376101315
	VISIT DATE: 12/02/2022

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. LPA also informed licensee 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.

LPA discussed 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. Any minor upon his/her 18^th birthday must be fingerprinted within 30 days.

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.

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platform. To receive important licensed-related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication. Applicant was encouraged to subscribe.

SUPERVISORS NAME: Tashima Daniel
LICENSING EVALUATOR NAME: Tyra Block
LICENSING EVALUATOR SIGNATURE:	DATE: 12/02/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/02/2022

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: GULED, FARHIYA FAMILY CHILD CARE	FACILITY NUMBER: 376101315
	VISIT DATE: 12/02/2022

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Licensee was reminded of required postings, requirements for children’s records, child abuse, and unusual incident reporting, immunizations, adults living or working in the home and associated civil penalties, applicant was also reminded that corporal punishment, smoking, walkers, exersaucers, bouncy seats and jumpers are not allowed in day care. All equipment that is used should be used only as intended by the manufacturer. LPA provided information regarding Safe Sleep Regulations/SIDS and Shaken Baby Syndrome. LPA and Licensee discussed California Megan's Law and LPA provided: www.meganslaw.ca.gov

Licensee is advised to regularly visit the Community Care Licensing WEB SITE: http://www.ccld.ca.gov/ for forms and updated regulation information. Duty Line was provided: (619) 767-2248. Southern California Child Care Advocate information was provided: (714) 703-2800 or childcareadvocatesprogram@dss.ca.gov.

The following corrections are required:
Preventative Health and Safety w/ Lead Poisoning Prevention
Child lever locks
Lease signed by landlord
Barricade for stairs (licensee cares for children under 5 years)

A provisional license will be issued effective today, expiring in 90 days. Once all corrections are made and proof is sent to licensing a regular license for 14 children will be granted. Licensee stated she will submit corrections for lever locks and barricade within 24 hours.

LPA discussed the following with licensee: MAX. CAP (WHEN THERE IS AN ASSISTANT PRESENT): 12 - NO MORE THAN 4 INFANTS. CAP 14 - NO MORE THAN 3 INFANTS. 1 CHILD IN
KINDERGARTEN OR ELEMENTARY SCHOOL AND 1 CHILD AT LEAST AGE 6. Licensee's own children under 10 are to be included in total capacity.

When caring for more than 12 children, Landlord Consent must be on file in licensing folder and Parent Notification of Additional Children in Care must be maintained in each child's file. .

Exit interview conducted and report was reviewed with licensee, Farhiya Guled.

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

SUPERVISORS NAME: Tashima Daniel
LICENSING EVALUATOR NAME: Tyra Block
LICENSING EVALUATOR SIGNATURE:	DATE: 12/02/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/02/2022

LIC809 (FAS) - (06/04)

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