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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376102152
Report Date: 08/09/2024
Date Signed: 08/09/2024 03:02:38 PM

Document Has Been Signed on 08/09/2024 03:02 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:HOSSAINI, NASIMA FAMILY CHILD CAREFACILITY NUMBER:
376102152
ADMINISTRATOR/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
08/09/2024
TYPE OF VISIT:PrelicensingANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:30 PM
MET WITH:Nasima HossainiTIME VISIT/
INSPECTION COMPLETED:
03:20 PM
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On August 9, 2024, at 1:30 PM., Licensing Program Analyst (LPA), Sherlynn Banas, conducted an announced Pre-Licensing inspection for change of location with Nasima Hossaini. The two-story house was toured and inspected to ensure an environment safe for the care and supervision of children. Licensee owns the home. The fire extinguisher (2A10BC), carbon monoxide detector, and smoke detector meet requirements and are operational. All hazardous items were latched/locked and secured out of reach of children. There is a fireplace in the living room. It is secured by a metal screen door. There is a jacuzzi which is locked on all sides. The licensee will add a gate to barricade the jacuzzi area. Licensee states that there are no weapons in the home. CPR and First Aid expire in February 2026. Mandated Report Certificate expires on December 7, 2025. A review of records on this date indicates that all residents, facility staff, or other individuals who require caregiver background checks have received criminal record and child abuse clearances or exemptions. Immunization requirements were met.

Licensee will be using the following rooms for childcare: living room, kitchen, dining room, daycare bedroom, patio/backyard, and bathroom. Off limits areas include the front yard where there is an empty fountain, all 3 bedrooms upstairs barricaded by a safety gate, garage ,and jacuzzi area. The applicant has toys and equipment available for children to use. Licensee understands supervision is required at all times for outdoor activities. The daycare bedroom will be used as an isolation area when a child gets sick. Licensee was advised no changes should be made to the home without prior notice and/or approval from Licensing.

Licensee was reminded of requirements for children’s records, child abuse, and unusual incident reporting, and immunizations, Adults living or working in the home are to be associated. If there is none, civil penalties, licensee was also reminded that corporal punishment, smoking, walkers, exersaucers, bouncy seats and jumpers are not allowed in day care. All equipment that is used should be used only as intended by the manufacturer. LPA discussed Shaken Baby Syndrome and current COVID Child Care Guidance. LPA and Licensee discussed California Megan's Law and LPA provided: www.meganslaw.ca.gov.
SUPERVISORS NAME: Tashima Daniel
LICENSING EVALUATOR NAME: Sherlynn Banas
LICENSING EVALUATOR SIGNATURE: DATE: 08/09/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/09/2024
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: HOSSAINI, NASIMA FAMILY CHILD CARE
FACILITY NUMBER: 376102152
VISIT DATE: 08/09/2024
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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-and-resources/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.

Licensee 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, 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 up to $500.00 maximum per day/per person will be assessed if this regulation is violated. Any minor residing in the home must obtain a background check within 30 days of his/ her 18th birthday.

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, 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: http://www.ada.gov/childqanda.htm.

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 platform.
To receive important licensed-related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.
SUPERVISORS NAME: Tashima Daniel
LICENSING EVALUATOR NAME: Sherlynn Banas
LICENSING EVALUATOR SIGNATURE:

DATE: 08/09/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/09/2024
LIC809 (FAS) - (06/04)
Page: 2 of 3
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: HOSSAINI, NASIMA FAMILY CHILD CARE
FACILITY NUMBER: 376102152
VISIT DATE: 08/09/2024
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Licensee is advised to regularly visit the Community Care Licensing WEB SITE: http://www.ccld.ca.gov/ for forms and updated regulation information. Duty Line was provided: (619) 767-2248. Southern California Child Care Advocate information was provided: (714) 703-2800 or childcareadvocatesprogram@dss.ca.gov.

The following corrections are to be done before a license will be issued:

1. Install a gate to the jacuzzi area.

Exit interview conducted and report was reviewed with the licensee, Nasimi Hossaini. Appeal Rights and a Notice of Site Visit was provided.

Reminder: maximum capacity for a small family childcare home: 4 infants only (infants mean any children under 24 months); or 6 children with no more than 3 infants; or (with landlord consent) 8 children with no more than 2 infants, 1 child in kindergarten or elementary school and 1 child at least age 6 including children under age 10 who live in the licensee's home.
SUPERVISORS NAME: Tashima Daniel
LICENSING EVALUATOR NAME: Sherlynn Banas
LICENSING EVALUATOR SIGNATURE:

DATE: 08/09/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/09/2024
LIC809 (FAS) - (06/04)
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