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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376101850
Report Date: 04/09/2026
Date Signed: 04/09/2026 02:44:47 PM

Document Has Been Signed on 04/09/2026 02:44 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 N. CC RO, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME:KHOSHNAW, FENIK FAMILY CHILD CAREFACILITY NUMBER:
376101850
ADMINISTRATOR/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 7CENSUS: 3DATE:
04/09/2026
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:30 AM
MET WITH:Fenik KhoshnawTIME VISIT/
INSPECTION COMPLETED:
02:30 PM
NARRATIVE
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On 4/9/26 at 8:30 AM, Licensing Program Analyst (LPA) Annette Sutherland , met with Licensee, Fenik Khoshnaw, to conduct the required annual inspection and a requested increase of capacity inspection. Licensee's husband Rawand Mam Sini was also present. There were 3 day care children present during the visit. The 1 story home was toured in its entirety to evaluate compliance with Title 22 regulations and to ensure the health and safety of children in care. The child care areas include the family room, dining room/area, bathroom #2, bedroom #2 and the kitchen. Areas made off-limits include Master bedroom and master bathroom , bedroom #3, bedroom #4, garage and backyard which were made inaccessible through the use of door knob covers and door locks. The fire clearance for the requested capacity increase was approved on February 9, 2026 . Adequate heating, lighting, and ventilation were observed throughout the licensed areas of the home. The licensee maintained the home in a clean and orderly condition. A working telephone was available for use in case of emergency. Age-appropriate toys, furnishings, and play equipment were observed to be in good condition and free of observable hazards. Home has a pool in the backyard. Pool has a fence , alarm, safety ring that meet regulations. Licensee understands she must have rescue pole with a body hook that is at least 12 feet long but must be long enough  to effectively rescue a child at the facility’s poo and a pool logl. The licensee confirmed that no firearms or other weapons are kept in the home. Detergents, cleaning compounds, medications, and other potentially hazardous items were stored inaccessible to children. LPA observed the fire extinguisher to be fully charged and operational. Smoke detectors and carbon monoxide detectors were tested and found to be operable at the time of inspection. Emergency exit routes were clear of obstructions.

CONTINUED ON LIC 809-C (PAGE 2)

NAME OF LICENSING PROGRAM MANAGER: Joelle Redding
NAME OF LICENSING PROGRAM ANALYST: Annette Sutherland
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 04/09/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/09/2026
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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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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Document Has Been Signed on 04/09/2026 02:44 PM - It Cannot Be Edited


Created By: Annette Sutherland On 04/09/2026 at 11:28 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108

FACILITY NAME: KHOSHNAW, FENIK FAMILY CHILD CARE
FACILITY NUMBER: 376101850

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/09/2026

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1596.814(a)(2)(A)
Pool Safety
(a) A licensed family daycare home operated at a private single-family dwelling with an in-ground swimming pool on the premises shall comply with all of the following requirements: (2) The licensee shall have the following safety equipment visible from the swimming pool and readily available for immediate use: (A) A life ring with a minimum exterior diameter of 17 inches and labeled as approved by the United States Coast Guard.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above and did not have a life ring, which poses a potential health, safety, or personal rights risk to persons in care.
POC Due Date: 04/09/2026
Plan of Correction
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Licensee made correction during the visit.
Type B
Section Cited
HSC
1596.814(a)(2)(B)
Pool Safety
(a) A licensed family daycare home operated at a private single-family dwelling with an in-ground swimming pool on the premises shall comply with all of the following requirements: (2) The licensee shall have the following safety equipment visible from the swimming pool and readily available for immediate use: (B) A rescue pole with a body hook and a minimum fixed length of 12 feet.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above and did not have a rescue pole with a body hook, which poses a potential health, safety, or personal rights risk to persons in care.
POC Due Date: 04/16/2026
Plan of Correction
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Licensee has purchased the required rescue pole with a body hook and is awaiting delivery. The licensee will send a photo of the rescue pole to LPA Annette.Sutherland@dss.ca.gov by 4/16/26.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Joelle Redding
NAME OF LICENSING PROGRAM MANAGER:
Annette Sutherland
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 04/09/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/09/2026


LIC809 (FAS) - (06/04)
Page: 3 of 9
Document Has Been Signed on 04/09/2026 02:44 PM - It Cannot Be Edited


Created By: Annette Sutherland On 04/09/2026 at 11:28 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108

FACILITY NAME: KHOSHNAW, FENIK FAMILY CHILD CARE
FACILITY NUMBER: 376101850

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/09/2026

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1596.814(a)(3)
Pool Safety
(a) A licensed family daycare home operated at a private single-family dwelling with an in-ground swimming pool on the premises shall comply with all of the following requirements: (3) A licensee shall perform a daily inspection of the drowning prevention safety features and safety equipment before opening the facility and maintain a log of the inspections to be provided to the department upon request.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on interview, the licensee did not comply with the section cited above and did not have a pool log, which poses a potential health, safety, or personal rights risk to persons in care.
POC Due Date: 04/16/2026
Plan of Correction
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Licensee will provide proof of conducting a pool log demonstrating that she will perform a daily inspection of the drowning prevention safety features and safety equipment before opening the family day care, and will maintain a log of the inspections. Licensee will provide proof to LPA by 4/16/26.
Type B
Section Cited
CCR
102425(j)(2)
Infant Safe Sleep
The provider shall supervise infants while they are sleeping and adhere to the following requirements: The provider shall check and document the following:

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on interview, the licensee did not comply with the section cited above and did not document the safe sleep 15minute checks, which poses a potential health, safety, or personal rights risk to persons in care.
POC Due Date: 04/16/2026
Plan of Correction
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Licensee will document the safe sleep 15 minute checks. Licnesee shall check and document the following: Infants up to 12 months of age who are sleeping in a position other than on their back. Labored breathing. Signs of distress, which include but are not limited to flushed skin color, increased body temperature, and restlessness. Licensee will provide proof to LPA by 4/16/26.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Joelle Redding
NAME OF LICENSING PROGRAM MANAGER:
Annette Sutherland
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 04/09/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/09/2026


LIC809 (FAS) - (06/04)
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Document Has Been Signed on 04/09/2026 02:44 PM - It Cannot Be Edited


Created By: Annette Sutherland On 04/09/2026 at 11:28 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108

FACILITY NAME: KHOSHNAW, FENIK FAMILY CHILD CARE
FACILITY NUMBER: 376101850

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/09/2026

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102421(a)
Child's Records
(a) The licensee shall maintain, in each child's record, the signed and dated notice form required in Section 102419(d).

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above. C1 did not have the Parent Notification additional children in care form (LIC 9150), which poses a potential health, safety, or personal rights risk to persons in care.
POC Due Date: 04/16/2026
Plan of Correction
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Licensee will provide proof that the LIC 9150 has been completed and signed and is in C1’s file. Licensee will submit proof by 4/16/26.
Type B
Section Cited
CCR
102417(g)(7)
Operation of A Family Child Care Home
(7) An emergency information card shall be maintained for each child and shall include the child's full name, telephone number and location of a parent or other responsible adult to be contacted in an emergency, the name and telephone number of the child's physician and the parent's authorization for the licensee or registrant to consent to emergency medical care.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above and did not have complete LIC 700 for C2, C3, and C4 which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 04/16/2026
Plan of Correction
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Licensee will provide proof that the LIC 700 has been completed by parents and in C2, C3, and C4's file. Licensee will submit proof by 4/16/26.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Joelle Redding
NAME OF LICENSING PROGRAM MANAGER:
Annette Sutherland
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 04/09/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/09/2026


LIC809 (FAS) - (06/04)
Page: 5 of 9
Document Has Been Signed on 04/09/2026 02:44 PM - It Cannot Be Edited


Created By: Annette Sutherland On 04/09/2026 at 11:28 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108

FACILITY NAME: KHOSHNAW, FENIK FAMILY CHILD CARE
FACILITY NUMBER: 376101850

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/09/2026

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102419(d)(1)
Admission Procedures and Authorized Representatives Rights
(d) At the time of acceptance of each child into care, the licensee shall provide the child's parent or authorized representative with a copy of the notice Family Child Care Home Notification of Parent's Rights, LIC 995A (8/06), the Caregiver Background Check Process, LIC 995E (6/05), and the Family child Care Consumer Awareness Information, LIC 9212 (10/05). (1) The licensee shall request the child's parent or authorized representative to sign and date the bottom portion of the notice form LIC 995A (8/06), which acknowledges that the parent or
authorized representative has received and read the LIC 995A. The bottom portion of this form
must be kept in the child’s file as proof that the parent or authorized representative has been
notified of his or her rights and received a copy of the Caregiver background Check Process, LIC
995E (6/05), and the Family Child Care Consumer Awareness Information, LIC 9212 (10/05).

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above in and did not have a LIC 995A which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 04/16/2026
Plan of Correction
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Licensee will provide proof that the LIC 995A has been completed and signed and is in C1’s file. Licensee will submit proof by 4/16/26.

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Joelle Redding
NAME OF LICENSING PROGRAM MANAGER:
Annette Sutherland
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 04/09/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/09/2026


LIC809 (FAS) - (06/04)
Page: 6 of 9
Document Has Been Signed on 04/09/2026 02:44 PM - It Cannot Be Edited


Created By: Annette Sutherland On 04/09/2026 at 11:28 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108

FACILITY NAME: KHOSHNAW, FENIK FAMILY CHILD CARE
FACILITY NUMBER: 376101850

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/09/2026

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102417(m)(3)
Operation of A Family Child Care Home
(3) A file of affidavits signed by each parent with a child enrolled in the home. The affidavit shall state that the parent has been informed that the family child care home does not carry liability insurance or a bond according to standards established by the state.

This requirement is not met as evidenced by:
Deficient Practice Statement
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4
Based on record review, the licensee did not comply with the section cited above and did not have the liability insurance form signed for Child 4, which poses a potential health, safety, or personal rights risk to persons in care.
POC Due Date: 04/16/2026
Plan of Correction
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Licensee will have parents sign the liability form, and proof will be sent to the LPA via email at Annette.Sutherland@dss.ca.gov by 4/16/26.
Type B
Section Cited
CCR
102425(c)
Infant Safe Sleep
An Individual Infant Sleeping Plan [LIC 9227 (3/20)] shall be completed for each infant up to 12 months of age the provider has in care and included in the infant's file at the facility.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above and did not have the LIC 9227 filled out completely, which poses a potential health, safety, or personal rights risk to persons in care.
POC Due Date: 04/09/2026
Plan of Correction
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C1 is already older then 12 months. Correction is not needed.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Joelle Redding
NAME OF LICENSING PROGRAM MANAGER:
Annette Sutherland
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 04/09/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/09/2026


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 N. CC RO, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME: KHOSHNAW, FENIK FAMILY CHILD CARE
FACILITY NUMBER: 376101850
VISIT DATE: 04/09/2026
NARRATIVE
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Outdoor space is a nearby park or recreation area. The licensee understands that supervision is required at all times when children are outdoors. A designated isolation area is available should a child become ill during the day. There were no jumpers or other prohibited equipment observed. All equipment used in care was used only as intended by the manufacturer. Children’s records were reviewed and corrections are needed. A current facility roster was maintained and provided upon request. The licensee maintains documentation of emergency disaster drills, and the most recent drill was conducted on 1/15/26. All required postings were posted. LPA reviewed staff and adult resident records. All adults living or working in the home have been fingerprint cleared and associated to the facility. 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. The licensee’s Pediatric CPR and First Aid certification was valid through 2/13/28 and meets the Emergency Medical Services Authority (EMSA) standards. The licensee completed the required Mandated Reporter Training on 3/1/26, and understands that the training must be renewed every two years. LPA verified that the licensee have met immunization requirements. LPA did observe an infant in care. 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. Licensee did no have any safe sleep logs to review. The facility does not currently provide Incidental Medical Services (IMS). LPA discussed the IMS policy and explained that when IMS is provided, a Plan for Providing IMS must be submitted to the Department. The licensee was provided with guidance available in Provider Information Notice PIN 22-02-CCP. Additional ADA resources were discussed, including the U.S. Department of Justice ADA Information Line at (800) 514-0301 (voice) or (800) 514-0383 (TTY), and the publication “Commonly Asked Questions About Child Care Centers and the ADA,” which is available online at https://www.ada.gov/resources/child-care-centers/.

CONTINUED ON LIC 809-C (PAGE 3)

NAME OF LICENSING PROGRAM MANAGER: Joelle Redding
NAME OF LICENSING PROGRAM ANALYST: Annette Sutherland
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 04/09/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/09/2026
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 N. CC RO, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME: KHOSHNAW, FENIK FAMILY CHILD CARE
FACILITY NUMBER: 376101850
VISIT DATE: 04/09/2026
NARRATIVE
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Licensee was informed of the MyChildCarePlan.org website; 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. LPA also provided the licensee with the Child Care Advocates Program contact email at childcareadvocatesprogram@dss.ca.gov, and advised the licensee that questions regarding licensing requirements may be directed to the Child Care Duty Line at (619) 767-2248.

See LIC809D for deficiencies cited.

Failure to make corrections will result in re-citation and/or civil penalties.

Upon final review of the capacity increase request, and once all corrections are received, a license to care for 14 children may be issued. An exit interview was conducted with the licensee, and this report was reviewed in its entirety. A copy of the report was provided. Appeal rights were reviewed and issued. A Notice of Site Visit was provided and must remain posted for 30 consecutive days.

NAME OF LICENSING PROGRAM MANAGER: Joelle Redding
NAME OF LICENSING PROGRAM ANALYST: Annette Sutherland
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 04/09/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/09/2026
LIC809 (FAS) - (06/04)
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