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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376628691
Report Date: 09/07/2022
Date Signed: 09/07/2022 06:40:10 PM

Document Has Been Signed on 09/07/2022 06:40 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:YUSIF, ADAM & FARAH, UBAH FAMILY CHILD CAREFACILITY NUMBER:
376628691
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 9DATE:
09/07/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
03:15 PM
MET WITH:Adam Yusif and Ubah FarahTIME COMPLETED:
06:30 PM
NARRATIVE
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On September 7, 2022 at 3:15PM, LPA, Luigi Gargaro, conducted an unannounced case management visit for a capacity increase visit with the co-licensees. The one story home was toured and inspected to ensure an environment safe for the care and supervision of children. When analyst arrived at the facility, the licensees were present with their own five children. Four additional day care children arrived during the visit. The fire extinguisher and smoke and carbon monoxide detectors meet requirements and are operational. All hazardous items were latched/locked and secured out of reach of children. Analyst inquired of the licensees about whether there were any bodies of water or weapons in the home and they replied no. 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. The home appears to be large enough to comfortably accommodate 14 children. Fire clearance was received on 08/31/22 by the San Diego Fire Department. Co-licensee Yusuf's CPR First Aid certification expires on April 3, 2023..

Licensees will be using the following rooms for childcare: the kitchen, the living room, the third and fourth bedrooms and the second bathroom. The fourth (or back) bedroom is currently set up as a day care room. The following areas will be off limits: the first two bedrooms, the first bathroom and the garage. The off limits bedrooms and bathroom are made that way with door knob covers that are installed on their respective door handles. The garage is made off limits with a locking door handle and a highly placed latch and bolt. The home has wall heating units that the licensees state are inoperable. However, licensees understand that if they ever are made operable, the heaters are to be made inaccessible to day care children with the installation of safety gates or other security devices.

The home fireplace in the back day care room is made inaccessible with a wooden board that is secured in its entrance. The licensees have sufficient toys and equipment available. The home has a fenced backyard available for outdoor activities. The licensees stated that the children primarily play in the concrete portion of the yard. The grass portion which is overgrown and a potential tripping hazard is typically not used. Licensees will provide direct supervision whenever day care children are playing in the backyard.
SUPERVISORS NAME: Jason Garay
LICENSING EVALUATOR NAME: Luigi Gargaro
LICENSING EVALUATOR SIGNATURE: DATE: 09/07/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/07/2022
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
CCLD Regional Office, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME: YUSIF, ADAM & FARAH, UBAH FAMILY CHILD CARE
FACILITY NUMBER: 376628691
VISIT DATE: 09/07/2022
NARRATIVE
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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. LPA and licensee discussed California Megan's Law and he provided licensees with the website address: www.meganslaw.ca.gov for them to review information regarding their facility on a regular basis.

The following information was reviewed with the licensees: information on reporting requirements for suspected child abuse and unusual incidents, children’s records, immunizations, adults living or working in the home and related civil penalties, shaken baby syndrome, and SIDS. Licensees were reminded that corporal punishment, smoking, walkers, exersaucers, bouncy seats and jumpers are not allowed in day care.

Licensees were cited a type B violation today for being overcapacity with nine children in care during today's visit. As the overcapacity is to be corrected with the issuance of a large license from today's visit, no further action is required and a license for 14 will be granted effective today. Analyst printed a copy of the Notice Of Site Visit today and had licensees place it in their facility notice area before he left the home.
SUPERVISORS NAME: Jason Garay
LICENSING EVALUATOR NAME: Luigi Gargaro
LICENSING EVALUATOR SIGNATURE:

DATE: 09/07/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/07/2022
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Document Has Been Signed on 09/07/2022 06:40 PM - It Cannot Be Edited


Created By: Luigi Gargaro On 09/07/2022 at 05:09 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: YUSIF, ADAM & FARAH, UBAH FAMILY CHILD CARE
FACILITY NUMBER: 376628691

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/07/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/07/2022
Section Cited
CCR
102416.5(a)

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102416.5 Staffng Ratio and Capacity - (a) The capacity specified on the license shall be the maximum number of children for whom care may be provided at any one time.

This requirement was not met as evidenced by:
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The children present today were comprised of five of the licensees' own children with a second family of four children who arrived at the home during analyst's visit. Licensees understand they are never to go above the amount of children allowed for their license and state will maintain the proper capacity and ratio going forward.
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Based on LPA’s observation, the licensees had nine children in care, which is one more than their license for eight allows, which poses a potential health and safety risk to children in care.
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Capacity issue is corrected as facility is approved for a large license today and will now have a capacity for up to 14 children 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:Jason Garay
LICENSING EVALUATOR NAME:Luigi Gargaro
LICENSING EVALUATOR SIGNATURE:
DATE: 09/07/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/07/2022


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