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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376626656
Report Date: 05/16/2023
Date Signed: 05/16/2023 01:50:21 PM

Document Has Been Signed on 05/16/2023 01:50 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
CCLD Regional Office, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME:AHMED, HAWA FAMILY CHILD CAREFACILITY NUMBER:
376626656
ADMINISTRATOR:HAWA AHMEDFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(858) 345-7637
CITY:SAN DIEGOSTATE: CAZIP CODE:
92126
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 2DATE:
05/16/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Hawa AhmedTIME COMPLETED:
02:05 PM
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On 5/16/2023 @ 1:00PM, LPA Nancy Diaz conducted an unannounced inspection in reference to the inspection conducted on 5/3/2023 that was written under the wrong facility license (with the same licensee name). This inspection was written under facility #376100590.

Licensee's son Abdirashid Ali was home, explained that Mrs. Ahmed is on her way home. Mrs. Ahmed arrived at 1:42pm with 2 daycare children.

NO DEFICIENCY CITED TODAY.
SUPERVISORS NAME: Tashima Daniel
LICENSING EVALUATOR NAME: Nancy Diaz
LICENSING EVALUATOR SIGNATURE: DATE: 05/16/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/16/2023
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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