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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376102024
Report Date: 10/23/2024
Date Signed: 10/23/2024 12:36:17 PM

Document Has Been Signed on 10/23/2024 12:36 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:SHAKER, NAGHAM FAMILY CHILD CAREFACILITY NUMBER:
376102024
ADMINISTRATOR/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: DATE:
10/23/2024
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:50 AM
MET WITH:Nagham ShakerTIME VISIT/
INSPECTION COMPLETED:
12:50 PM
NARRATIVE
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On October 23, 2024, at 10:50 a.m., Licensing Program Analyst (LPA), Sherlynn Banas met with Nagham Shaker for the purpose of increase in capacity from eight (8) to fourteen (14) children. Nabil Toma (husband) was also present and greeted LPA Banas. One child was present when LPA Banas arrived at daycare. Licensee has 7 enrolled children.

LPA toured the home. There are two bedrooms and two bathrooms. All required forms were posted. There is a working telephone on the premises. There are no bodies of water or weapons/firearms or ammunition in the home or on the property. There is a common pool at the complex far from the home which has always been locked. The fire extinguisher size (2A10BC) meets requirements and is fully charged, located in the kitchen. The smoke detector and carbon monoxide detector are mounted on the dining room wall and is operational. Applicant’s Pediatric CPR/FA certification is valid through 5/2026. Control of property was verified today. The Fire Safety Inspection Request (STD 850) was approved by the local fire marshal and GRANTED the capacity increase to fourteen (14) children on 10/17/2024.

Applicant will be using the following areas for childcare: living room, dining room, bathroom, garage, and the fenced backyard. Off limits areas of the home is the kitchen and all the second floor which is barricaded by a safety gate going upstairs. Off limit areas has been inaccessible with the use of doorknob covers.
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Outdoor play area is fenced and equipped with age-appropriate play structure and toys and are in good condition. Applicant was reminded of requirements for children’s records, child abuse reporting, unusual incident reporting, immunization, criminal background clearance procedures and policies, and posting requirements.

LPA reviewed the Fire drill which was last October 2024. 3 child records were reviewed.
SUPERVISORS NAME: Tashima Daniel
LICENSING EVALUATOR NAME: Sherlynn Banas
LICENSING EVALUATOR SIGNATURE: DATE: 10/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/23/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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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: SHAKER, NAGHAM FAMILY CHILD CARE
FACILITY NUMBER: 376102024
VISIT DATE: 10/23/2024
NARRATIVE
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Applicant was reminded that walkers, exersaucers, bouncy seats, jumpers, drop side cribs and napping portables are not to be used for day care. Smoking during in or around day care areas is prohibited. Current children's records and the roster were reviewed today.

Licensee was reminded of the staffing/capacity ratios for Large Family Child Care Homes. Twelve (12) children, no more than 4 infants (birth to 24 months) and 8 older children over the age of 2. A qualified assistant (age 14 or older) is required. For fourteen (14) children, no more than 3 infants (birth to 24 months) and 11 older children; at least 2 school age, 1 child at least age 6, 1 child enrolled in and attending kindergarten or elementary school. When there isn't a qualified assistant, licensee must follow Small Family Home Child Care Regulations.

LPA discussed with Licensee the safe sleep regulations and 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 [facility representative] 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. . Licensee is reminded that infants may not be swaddled while in care and walkers, exersaucers, jumpers, bouncy seats, napping portables and drop sided cribs are not permitted for use.

In case of a child getting sick, an isolation will be in the area in the living Room.
SUPERVISORS NAME: Tashima Daniel
LICENSING EVALUATOR NAME: Sherlynn Banas
LICENSING EVALUATOR SIGNATURE:

DATE: 10/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/23/2024
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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: SHAKER, NAGHAM FAMILY CHILD CARE
FACILITY NUMBER: 376102024
VISIT DATE: 10/23/2024
NARRATIVE
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Licensee is advised to signed up for Quarterly Updates and Provider Information Notices (PINs) for one or more programs on our website: www.ccld.ca.gov.

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, an updated Plan of Operation that includes 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.

A deficiencies cited during today’s visit. (see 809D)



A license for a capacity of fourteen (14) will be issued after final file review. An exit interview was conducted, the report was reviewed with Licensee, Nagham Shaker. A 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: 10/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/23/2024
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Document Has Been Signed on 10/23/2024 12:36 PM - It Cannot Be Edited


Created By: Sherlynn Banas On 10/23/2024 at 12:08 PM
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: SHAKER, NAGHAM FAMILY CHILD CARE
FACILITY NUMBER: 376102024

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/23/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
10/28/2024
Section Cited
CCR
102417(g)(8)

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Each family childcare home shall have a current roster of childrenas specified in Health & Safety Code Section1596.841.

The requirement was not met as evidenced by:
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Licensee, Nagham Shaker will send proof of roster to LPA Banas email on or before October 28, 2024.
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Based on record review, the licensee did not comply with having a roster of children which poses a potential health, safety or personal rights risk to persons in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Tashima Daniel
LICENSING EVALUATOR NAME:Sherlynn Banas
LICENSING EVALUATOR SIGNATURE:
DATE: 10/23/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/23/2024


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