376101652-8-31-2023-51-CC-GCUS-CV8PF3-20230831111605

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 376101652
Report Date: 08/31/2023
Date Signed: 08/31/2023 11:16:13 AM

Document Has Been Signed on 08/31/2023 11:16 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:	NOORI, SHAFIQA FAMILY CHILD CARE		FACILITY NUMBER:	376101652
ADMINISTRATOR:	SHAFIQA NOORI		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(619) 966-8818
CITY:	EL CAJON	STATE: CA	ZIP CODE:	92020
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS: 0	DATE:	08/31/2023
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME BEGAN:	08:50 AM
MET WITH:	Shafiqa Noori		TIME COMPLETED:	11:30 AM

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	On August 31, 2023 at 8:50 a.m. Licensing Program Analyst (LPA) Leilani Curtis conducted an announced pre-licensing/change of location inspection with applicant, Shafiqa Noori. Also present was the applicant’s husband Siraj Uddin Noori who translated for the applicant. The applicant’s primary language is Pashto. The purpose of the inspection is to ensure that the home is in compliance with standards established in CCR, Title 22, Division 12, Chapter 3. This 3 bedroom, 3 bathroom home was toured and inspected to ensure an environment safe for the care and supervision of children. Because the applicant rents/leases the home, proof of landlord notification is required. The LPA observed the Property Owner/Landlord Notification form (LIC9151) that the applicant confirms was provided to the property owner/landlord. The applicant obtained a signed Property Owner/Landlord Consent form (LIC 9149). A fire clearance allowing the applicant to operate with a capacity of 14 children was received on 8/16/23. The home appears to be large enough to comfortably accommodate 14 children. Applicant will use the following areas for child care: living room/hall, kitchen/dining area, bedroom #1, bathroom #1 and enclosed rear yard. Off limits areas include: bedroom #2, bedroom #3, bathroom #2 and bathroom #3. There are no stairs in the home. Applicant will utilize the enclosed rear yard for outdoor activities. There are no bodies of water observed during time of visit. The fire extinguisher, smoke and carbon monoxide detector meet requirements and are operational. All poisons, cleaners and hazardous items in the home are inaccessible to children through latches, locks, and/or placed up on high surfaces. Children’s toys and play equipment are available. Applicant states there are NO firearms or other weapons in the home. Applicant has completed the 8 hours of preventative health training. Pediatric CPR and First Aid certifications expire in 03/2025. A review of staff records on this date indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse clearances or exemptions. Applicant has completed the Mandated Child Abuse Reporting-per AB1207. LPA reviewed certification and it is in compliance. Immunization records per SB792 were reviewed and are in compliance for all personnel that will be providing care and supervision to children. Required documents are posted. Applicant is reminded to make anything that reads, "Keep Out of Reach of Children" inaccessible to children.

SUPERVISORS NAME: Tashima Daniel
LICENSING EVALUATOR NAME: Grace Curtis
LICENSING EVALUATOR SIGNATURE:	DATE: 08/31/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/31/2023

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)

Page: 1 of 3

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: NOORI, SHAFIQA FAMILY CHILD CARE	FACILITY NUMBER: 376101652
	VISIT DATE: 08/31/2023

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
26
27
28
29
30
31
32

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) or (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.

The New Provider Resource Packet was reviewed with the applicant including information on the following: SIDS, shaken baby syndrome, effects of lead, insurance, child abuse reporting, community resources, immunization's, car seat law, visual for ratio/capacity, prohibited items handout (walkers, exersaucers, jumpers and bouncy seats), fire/disaster drill log, safe sleep log, and the YMCA Resource Center. The applicant was also reminded that corporal punishment and smoking are not allowed in the day care. LPA discussed California Megan's Law and provided: www.meganslaw.ca.gov.

On this date, 08/09/2023, the California Attorney General - Megan’s Law website was searched for information on sex offenders required to register with local law enforcement under California's Megan's Law. No registered sex offenders were found at the facility addresses. Under state law, some registered sex offenders are not subject to public disclosure; therefore, they may not have been included in this search. However, the Department conducts a monthly cross reference of each address on record for all registered sex offenders against all CCLD facility addresses pursuant to information shared by California DOJ.

Applicant was reminded that all adults 18 and over living in the home, persons who provide care and supervision to children, and staff who have contact with children, 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: Grace Curtis
LICENSING EVALUATOR SIGNATURE:	DATE: 08/31/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/31/2023

LIC809 (FAS) - (06/04)

Page: 3 of 3

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: NOORI, SHAFIQA FAMILY CHILD CARE	FACILITY NUMBER: 376101652
	VISIT DATE: 08/31/2023

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
26
27
28
29
30
31
32

LPA discussed the safe sleep regulations with applicant 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 applicant 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 reviewed with applicant the LIC 311D, Forms/Records to Keep In Your Family Child Care Homes, children’s forms/records, facility forms/records, and information to be posted. Entrance Checklist was provided to the applicant.

Applicant was informed of the MyChildCarePlan.org site, a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

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 platforms. To receive important licensed related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-carelicensing/subscribe and select the Child Care option to receive email communication.

***A Large Family Child Care Home License may be issued upon final file review. Applicant states that she will comply with all regulations and laws governing family child care homes and that she is financially secure to operate a family child care home for children.

Exit interview conducted and report was reviewed with Applicant Shafiqa Noori. Siraj Uddin Noori translated this report into Pashto for the applicant.

A notice of site visit was given to applicant and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days.

SUPERVISORS NAME: Tashima Daniel
LICENSING EVALUATOR NAME: Grace Curtis
LICENSING EVALUATOR SIGNATURE:	DATE: 08/31/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/31/2023

LIC809 (FAS) - (06/04)

Page: 2 of 3