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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376101318
Report Date: 03/03/2023
Date Signed: 03/03/2023 10:59:43 AM

Document Has Been Signed on 03/03/2023 10:59 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:ALI, MUNISA FAMILY CHILD CAREFACILITY NUMBER:
376101318
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 0DATE:
03/03/2023
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
10:45 AM
MET WITH:Munisa AliTIME COMPLETED:
11:05 AM
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On 3/3/23 at 10:45 AM, Licensing Program Analyst (LPA) Keturah Lane made a second pre-licensing inspection at the facility to follow up on corrections requested at the first inspection on 2/10/23. Corrections were needed to repair the fence in the backyard and obtain a functioning carbon monoxide detector. Licensee attempted to send pictures/video of corrections but had technical issues. Upon arrival, LPA met with applicant Munisa Ali and approved the corrections. Fence has been repaired and applicant obtained a functioning carbon monoxide detector. A license for 8 children may be granted upon final file review. Applicant understands she must obtain landlord consent to care for more than 6 children. Applicant agreed to comply with all regulations and laws governing family child care home. Applicant stated interest in applying for a capacity increase and stated she has previous center experience and education credits. LPA advised her to send proof of via e-mail before applying for the capacity increase. Home appears to be large enough for 12-14 children.

Exit interview conducted and report was reviewed with applicant Munisa Ali.

SUPERVISORS NAME: Monica Cuddy
LICENSING EVALUATOR NAME: Keturah Lane
LICENSING EVALUATOR SIGNATURE: DATE: 03/03/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/03/2023
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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