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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376101367
Report Date: 03/22/2024
Date Signed: 03/22/2024 12:12:34 PM

Document Has Been Signed on 03/22/2024 12:12 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
SAN DIEGO NORTH, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME:MOHAMED, MANA FAMILY CHILD CAREFACILITY NUMBER:
376101367
ADMINISTRATOR:MANA MOHAMEDFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(619) 808-7251
CITY:SAN DIEGOSTATE: CAZIP CODE:
92115
CAPACITY: 12TOTAL ENROLLED CHILDREN: 2CENSUS: 0DATE:
03/22/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Mana MohamedTIME COMPLETED:
12:30 PM
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On March 22, 2024 at 10:30 am Licensing Program Analyst (LPA) Sherlynn Banas conducted an unannounced annual inspection to verify that the licensee remains in substantial compliance with the health & safety standards as required by regulations governing family childcare homes. LPA was greeted by Mana Mohamed. LPA introduced herself and showed her identification. Licensee stated that she has 2 children enrolled. There were no children present at this time. She stated that she will pick up the children at 2:00 PM. Licensee has required forms posted. Fire clearance was granted on 12/16/23. First Aid and CPR certifications expire on 11/2024. Applicant completed Mandated Reporter Training and expired on 1/6/24 and is reminded it must be taken every 2 years. Children’s records were reviewed and found to be in order. Licensee's last Fire Drill was on December 13, 2023. Licensee stated that her next Fire Drill will be in June 2024. Licensee rents the house.

This one story, 4 bedroom, 4 bathroom home was toured and inspected to ensure an environment safe for the care and supervision of children. Applicant has provided adequate space for the children to eat, sleep and play within the home. Accessible areas for the children are the following areas: living room, dining room, kitchen, bathroom #1 and backyard. Drawers and lower cabinets in kitchen/bathroom are either latched or do not contain any hazardous items. Off limit areas include Bedrooms 1, 2, 3, and 4; and bathroom 2,3, 4, and garage. Off limit areas have been made inaccessible with the use of doorknob covers. There is a working phone at the facility. The licensee has sufficient age appropriate, safe, toys and equipment available. Licensee rents the home. The carbon monoxide, smoke detector and fire extinguisher were all operational. The smoke detector is by the hallway; the carbon monoxide and fire extinguisher were located by the kitchen.
SUPERVISORS NAME: Tashima Daniel
LICENSING EVALUATOR NAME: Sherlynn Banas
LICENSING EVALUATOR SIGNATURE: DATE: 03/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/22/2024
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
SAN DIEGO NORTH, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME: MOHAMED, MANA FAMILY CHILD CARE
FACILITY NUMBER: 376101367
VISIT DATE: 03/22/2024
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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-andresources/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.

Children will be observed upon entry and throughout the day for signs of illness. An appropriate isolation area has been established for sick children. The isolation area will be in another area in the living room away from the other children. Reporting requirements for positive Covid-19 results in children or staff were discussed to include contact with County Department of Public Health for guidance (619-692-8499) and Licensing (619-767-2248) to report the unusual incident for THREE or more cases.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02- CCP. 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: https://www.ada.gov/resources/child-care-centers/.

Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.
SUPERVISORS NAME: Tashima Daniel
LICENSING EVALUATOR NAME: Sherlynn Banas
LICENSING EVALUATOR SIGNATURE:

DATE: 03/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/22/2024
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
SAN DIEGO NORTH, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME: MOHAMED, MANA FAMILY CHILD CARE
FACILITY NUMBER: 376101367
VISIT DATE: 03/22/2024
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Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain childcare by connecting them to childcare providers and Resource and Referral Agencies Licensee is to be present in the home to ensure children are supervised and reminded that no children are to be left in parked vehicles and car seats are not to use used for sleeping. Capacity limitations were reviewed. LPA discussed California Megan's Law and the website was provided as follows: www.meganslaw.ca.gov

Licensee is advised to sign up for Quarterly Updates and Provider Information Notices (PINs) for one or more programs on our website: www.ccld.ca.gov. Select “Child Care” then “Quick Links” and Quarterly Updates. Select “Receive Important Updates” then put the email address in and choose which program you would like to subscribe to and select “subscribe.”

To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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

Exit interview conducted, report was reviewed, and Appeal rights was provided to the licensee, Mana Mohamed.

During the exit interview, Mana Mohamed confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

No Deficiencies are cited.

NOTICE OF SITE VISIT WAS GIVEN AND MUST REMAIN POSTED FOR 30 DAYS.

SUPERVISORS NAME: Tashima Daniel
LICENSING EVALUATOR NAME: Sherlynn Banas
LICENSING EVALUATOR SIGNATURE:

DATE: 03/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/22/2024
LIC809 (FAS) - (06/04)
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