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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376628367
Report Date: 05/31/2024
Date Signed: 06/14/2024 08:10:18 AM

Document Has Been Signed on 06/14/2024 08:10 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
, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME:ADAM, MULKI FAMILY CHILD CAREFACILITY NUMBER:
376628367
ADMINISTRATOR/
DIRECTOR:		MULKI ADAMFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(619) 321-7110
CITY:SAN DIEGOSTATE: CAZIP CODE:
92115
CAPACITY: 14TOTAL ENROLLED CHILDREN: 10CENSUS: 0DATE:
05/31/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:50 AM
MET WITH:Mulki AdamTIME VISIT/
INSPECTION COMPLETED:
12:30 PM
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On 5/31/24 at 10:53 a.m., Licensing Program Analyst (LPA) Renita Rodriguez conducted an unannounced annual inspection with the Licensee, Mulki Adam. Upon arrival, LPA identified herself and presented badge. The 1 bedroom 1 bathroom apartment was toured and inspected to ensure an environment safe for the care and supervision of children. Present in the home was licensee only. No children in care were present.

Licensee has provided adequate space for the children to eat, sleep and play within the home. Areas used for childcare include living room, kitchen, bedroom and bathroom. The licensee has sufficient toys and play equipment available.

The fire extinguisher (2A10BC), smoke detector, and carbon monoxide detector meet requirements and are operational. All hazardous items were latched/locked and secured out of reach of children. There is a community swimming pool which meets regulations. Licensee states that there are no weapons in the home. First Aid and CPR certifications expire on 5/6/2026. Licensee has required immunizations. Licensee will complete the Mandated Reporter Training by 6/10/24. Licensee is reminded it must be completed every 2 years. Children’s and Staff records were reviewed and found to be in order.

Licensee is hereby reminded of the following: Report suspected child abuse and neglect, maintain children’s records according to regulation, post all required forms; corporal punishment, smoking, exersaucers, bouncy seats, walkers, and jumpers are not allowed in day care.



All equipment that is used should be used only as intended by the manufacturer. LPA directed Licensee to website: https://www.cdss.ca.gov/inforesources/community-care-licensing to receive important updates and information.
LPA and Licensee discussed California Megan's Law and LPA provided: www.meganslaw.ca.gov.
SUPERVISORS NAME: Renesha Askew
LICENSING EVALUATOR NAME: Renita Rodriguez
LICENSING EVALUATOR SIGNATURE: DATE: 05/31/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/31/2024
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 N. CC RO, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME: ADAM, MULKI FAMILY CHILD CARE
FACILITY NUMBER: 376628367
VISIT DATE: 05/31/2024
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LPA discussed the safe sleep regulations with licensee and discussed the Childcare Licensing Safe Sleep web page 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.

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.
Licensee was reminded that all adults 18 and over living or working in the home, 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 Childcare 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.

LPA discussed and provided Licensee with the following: childcare advocates-email address: childcareadvocatesprogram@dss.ca.gov . In addition, for general questions or questions regarding licensing requirements contact the Childcare Licensing Duty Line at (619) 767-2248.



Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Childcare 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 Childcare Centers and the ADA, available at: http://www.ada.gov/childqanda.htm. There were no children present requiring services.

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 are available at: https://www.ada.gov/resources/child-carecenters.gov

SUPERVISORS NAME: Renesha Askew
LICENSING EVALUATOR NAME: Renita Rodriguez
LICENSING EVALUATOR SIGNATURE:

DATE: 05/31/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/31/2024
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: ADAM, MULKI FAMILY CHILD CARE
FACILITY NUMBER: 376628367
VISIT DATE: 05/31/2024
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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.


To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

LPA conducted childcare quality management interview with the Licensee. The Licensee, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

Technical Violation:
1596.8662(b)(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training.

Exit interview conducted and report was reviewed with the licensee Mulki Adam. A notice of site visit was given and must remain posted for 30 days.
SUPERVISORS NAME: Renesha Askew
LICENSING EVALUATOR NAME: Renita Rodriguez
LICENSING EVALUATOR SIGNATURE:

DATE: 05/31/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/31/2024
LIC809 (FAS) - (06/04)
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