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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376629503
Report Date: 11/19/2025
Date Signed: 11/19/2025 02:47:53 PM

Document Has Been Signed on 11/19/2025 02:47 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:SAID, FADUMA FAMILY CHILD CAREFACILITY NUMBER:
376629503
ADMINISTRATOR/
DIRECTOR:		FADUMA SAIDFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(626) 708-1250
CITY:SAN DIEGOSTATE: CAZIP CODE:
92105
CAPACITY: 14TOTAL ENROLLED CHILDREN: 26CENSUS: 4DATE:
11/19/2025
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:40 AM
MET WITH:Faduma Said & Fahmo WarsameTIME VISIT/
INSPECTION COMPLETED:
02:55 PM
NARRATIVE
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On November 19, at 9:40AM, Licensing Program Analyst (LPA), Luigi Gargaro, conducted an unannounced annual required inspection and met with the licensee, Faduma Said. LPA disclosed the purpose of the inspection and was granted entry into the facility by the Licensee's sister. Four (4) children and three (3) staff, including the licensee's two cleared and associated sisters, Fahmo Warsame and Ahsa Said, were present in the facility during this inspection. This facility is a two floor, five bedroom, three bathroom house. Licensee accompanied LPA inside and out of the facility during this inspection. The following areas used for child care are: the kitchen, the dining room area, the living room, the bedroom and the day care bathroom all located on the first floor of the home.

Off limits areas are the laundry room, the garage and the entire second floor of the home. The laundry room is made off limits with a door knob cover that is installed on the entrance door handle and a highly installed bolt and latch. The garage entry door from the home is immediately behind the inaccessible laundry room also making the garage inaccessible. The facility has two home fireplaces that are made appropriately inaccessible with installed screens.

The fire extinguisher and the combination smoke and carbon monoxide detector met requirements. Most hazardous items were inaccessible to children. The licensee has toys, play equipment and materials available. The home has a fenced backyard that is off limits to the day care as it contains personal and also potentially hazardous items she does not want the children to access. The yard is made off limits with the home exit and an additional metal gated door that both have door knob covers installed on their door handles. Licensee states she takes children to a local park for outdoor activity whenever necessary, instead.

No bodies of water observed on the premises during the inspection. Licensee stated there are no weapons in the home. 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.
NAME OF LICENSING PROGRAM MANAGER: Jason Garay
NAME OF LICENSING PROGRAM ANALYST: Luigi Gargaro
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 11/19/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/19/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 10
California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
Page: 2 of 10
Document Has Been Signed on 11/19/2025 02:47 PM - It Cannot Be Edited


Created By: Luigi Gargaro On 11/19/2025 at 12:06 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: SAID, FADUMA FAMILY CHILD CARE
FACILITY NUMBER: 376629503

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/19/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102417(g)
Operation of A Family Child Care Home
(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to:

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on analyst observation, the licensee did not comply with the section cited above as overhead computer cable wires were not secured and were accessible and possibly able to be grabbed by an older child and the cabinet below the kitchen sink, though it has latches on it, is not completely secured and may possibly be removed with an amount of force which poses/posed a potential health, safety or personal rights risk to children in care.
POC Due Date: 12/15/2025
Plan of Correction
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Licensee states the cable wires will be secured and the cabinet doors will be repaired and she will send analyst photos by 12/15/25 demonstrating that deficiencies have been corrected. In the meantime, licensee states she will increase supervision to ensure that children do not access the two areas. All chemical products were removed and made inaccessible to day care children.
Type B
Section Cited
CCR
102417(g)(3)
Operation of A Family Child Care Home
(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (3) Where children are less than five years old are in care, stairs shall be fenced or barricaded.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on analyst observation, the licensee did not comply with the section cited above as, during today's visit, the gate was not secured allowing children access to the staircase and the off limits upstairs of the home which poses/posed a potential health, safety or personal rights risk to children in care.
POC Due Date: 11/24/2025
Plan of Correction
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Licensee put the gate in place but as analyst determined the gate to be unstable and not potentially prevent children from accessing the staircase, licensee states she will look for alternative solutions to make the staircase inaccessible and send them to analyst by 11/24/25 for review before installing them. In the meantime, the baby gate will remain in place and the licensee and assistants will provide increased supervision to prevent children from accessing the staircase until the gate is replaced.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Jason Garay
NAME OF LICENSING PROGRAM MANAGER:
Luigi Gargaro
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 11/19/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/19/2025


LIC809 (FAS) - (06/04)
Page: 3 of 10
Document Has Been Signed on 11/19/2025 02:47 PM - It Cannot Be Edited


Created By: Luigi Gargaro On 11/19/2025 at 12:06 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: SAID, FADUMA FAMILY CHILD CARE
FACILITY NUMBER: 376629503

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/19/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102417(g)(4)
Operation of A Family Child Care Home
(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (4) Poisons, detergents, cleaning compounds, medicines, firearms and other items which could pose a danger if readily available to children shall be stored where they are inaccessible to children.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on analyst observation, the licensee did not comply with the section cited above as she had several personal products on the liv room end table that were labeled as "keep out of reach of children" which poses/posed a potential health, safety or personal rights risk to children in care. Violation was cited as a type B violation as the products were closed and the ratio of children to adults was a high one.
POC Due Date: 11/19/2025
Plan of Correction
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Licensee removed all products in question from the end table and moved them to an area the children could not reach. Licensee also understands that any product with that type of label, or something that may be a potential hazard to children in care, should be made inaccessible to them at all times.
Type B
Section Cited
CCR
102425(a)
Infant Safe Sleep
(a) There shall be one crib or play yard for each infant who is unable to climb out of the crib or play yard.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on analyst observation and interview, the licensee did not comply with the section cited above as a new infant in care (child #1) slept on the couch for a brief nap before being picked up which poses/posed a potential health, safety or personal rights risk to children in care.
POC Due Date: 11/20/2025
Plan of Correction
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Licensee brought out a crib she has that the child may be able to nap in but was not able to use today as she stated the mattress was not clean and the child was not able to sleep on it. Licensee stated she will send analyst a photo of the crib fully made up or purchase a new, separate piece of appropriate napping equipment and send analyst a photo of it by 11/20/25 to correct the deficiency.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Jason Garay
NAME OF LICENSING PROGRAM MANAGER:
Luigi Gargaro
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 11/19/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/19/2025


LIC809 (FAS) - (06/04)
Page: 4 of 10
Document Has Been Signed on 11/19/2025 02:47 PM - It Cannot Be Edited


Created By: Luigi Gargaro On 11/19/2025 at 12:06 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: SAID, FADUMA FAMILY CHILD CARE
FACILITY NUMBER: 376629503

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/19/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102425(b)(1)(A)
Infant Safe Sleep
(b) Cribs or play yards shall be free from all loose articles and objects. (1) Pacifiers shall be allowed in the crib or play yard if the following provisions are in place: (A) There shall not be anything attached to the pacifier.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on analyst observation, the licensee did not comply with the section cited above as an infant in care today (child #2) had a pacifier in her mouth which was attached to her shirt with a type of lanyard which poses/posed a potential health, safety or personal rights risk to infants in care.
POC Due Date: 11/19/2025
Plan of Correction
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Licensee removed the pacifier from the child and understands any child using one in the future can not have it secured to any type of lanyard or string as it may be a potential choking hazard. Licensee was also provided a copy of infant safe sleep regulations so that she can reveiw them and familiarize herself with the ongoing requirements.
Type B
Section Cited
CCR
102425(j)(2)(B)
Infant Safe Sleep
The provider shall supervise infants while they are sleeping and adhere to the following requirements: The provider shall check and document the following: Signs of distress which includes but is not limited to flushed skin color, increase in body temperature and restlessness.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above as the safe sleep log she provided for analyst to review for child #2 did not follow regulation documentation parameters as she wsa not chekcing on the infant every 15 minutes and documenting it as required which poses/posed a potential health, safety or personal rights risk to infants in care.
POC Due Date: 12/01/2025
Plan of Correction
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Analyst provided licensee with a copy of a sample safe sleep log and reviewed the required way to document children's naps. Licensee states that she will document naps as required.going forward from this point on and provide analyst with copies of the documented log sheets for the period of 11/20/25 - 11/28/25 and then submit logs for chld #2 and newly enrolled child #1 by 12/01/25 to correct the deficiency.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Jason Garay
NAME OF LICENSING PROGRAM MANAGER:
Luigi Gargaro
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 11/19/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/19/2025


LIC809 (FAS) - (06/04)
Page: 5 of 10
Document Has Been Signed on 11/19/2025 02:47 PM - It Cannot Be Edited


Created By: Luigi Gargaro On 11/19/2025 at 12:06 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: SAID, FADUMA FAMILY CHILD CARE
FACILITY NUMBER: 376629503

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/19/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1596.8662(b)(1)
Administration of Child Day Care Licensing
(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.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on analyst record review, the licensee did not comply with the section cited above as she and her sister assisting her with care today, Asha Said, did not have current Mandated Reporter Training Certificates which poses/posed a potential health, safety or personal rights risk to children in care.
POC Due Date: 12/22/2025
Plan of Correction
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Licensee states she and her sister will complete an approved on-line Mandated Reporter Training class and send analyst a copy of the certificate of completion by 12/22/25 to correct the deficiency.
Type B
Section Cited
HSC
1597.622(c)
Administration of Child Day Care Licensing
(c) The family day care home shall maintain documentation of the required immunizations or exemptions from immunization, as set forth in this section, in the person's personnel record that is maintained by the family day care home.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on analyst record review, the licensee did not comply with the section cited above as both her sisters assisting in care today did not have a copy of their required immunizations on file today which poses/posed a potential health, safety or personal rights risk to children in care.
POC Due Date: 12/22/2025
Plan of Correction
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Licensee states she wiil obtain copies of her sisters' shot records and send them to analyst by 12/22/25 to correct the deficiency.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Jason Garay
NAME OF LICENSING PROGRAM MANAGER:
Luigi Gargaro
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 11/19/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/19/2025


LIC809 (FAS) - (06/04)
Page: 6 of 10
Document Has Been Signed on 11/19/2025 02:47 PM - It Cannot Be Edited


Created By: Luigi Gargaro On 11/19/2025 at 12:06 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: SAID, FADUMA FAMILY CHILD CARE
FACILITY NUMBER: 376629503

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/19/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102416(c)
Personnel Requirements
(c) The licensee and other personnel as specified shall complete training on preventive health practices, including pediatric cardiopulmonary resuscitation and pediatric first aid, pursuant to Health and Safety Code Section 1596.866.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on analyst record review, the licensee did not comply with the section cited above as neither she or her assisting sisters had current CPR/First Aid certifications which poses/posed a potential health, safety or personal rights risk to children in care.
POC Due Date: 12/22/2025
Plan of Correction
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2
3
4
Licensee states she and her sisters will take an EMSA certified CPR/First Aid training class and send analyst a copy of the certificates of completion by 12/22/25 to correct the deficiency.
Type B
Section Cited
CCR
102418(a)
Immunizations
(a) Prior to admission to a family day care home, children shall be immunized against diseases as required by the California Code of Regulations, Title 17, beginning with Section 6000.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on analyst record review, the licensee did not comply with the section cited above as none of the children in care had copies of their immunizations on file which poses/posed a potential health, safety or personal rights risk to children in care.
POC Due Date: 12/22/2025
Plan of Correction
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Licensee was provided with blank blue immuniztion cards and states will obtain copies of children's yellow shot cards, transfer them to the blue cards and send them to analyst for all children whose records were reviewed today by 12/22/25 to correct the violation.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Jason Garay
NAME OF LICENSING PROGRAM MANAGER:
Luigi Gargaro
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 11/19/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/19/2025


LIC809 (FAS) - (06/04)
Page: 7 of 10
Document Has Been Signed on 11/19/2025 02:47 PM - It Cannot Be Edited


Created By: Luigi Gargaro On 11/19/2025 at 12:06 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: SAID, FADUMA FAMILY CHILD CARE
FACILITY NUMBER: 376629503

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/19/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102421(b)
Child's Records
(b) The licensee shall maintain, in each child's record, a copy of the emergency information card as required
in Section 102417(g)(7).

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on analyst record review, the licensee did not comply with the section cited above as she did not have a record file for child #1, a new infant in care, which poses/posed a potential health, safety or personal rights risk to children in care.
POC Due Date: 11/24/2025
Plan of Correction
1
2
3
4
Licensee states she will have parent complete a records packet for child #1 and send copies of the completed packet by 11/24/25 to complete the correction.
Type B
Section Cited
CCR
102417(g)(8)
Operation of A Family Child Care Home
(8) Each family child care home shall have a current roster of children as specified in Health and Safety Code Section 1596.841.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on analyst record review, the licensee did not comply with the section cited above as the roster she maintains does not have all the required information found on the facility roster form which poses/posed a potential health, safety or personal rights risk to children in care.
POC Due Date: 11/24/2025
Plan of Correction
1
2
3
4
Analyst provided analyst with a blank facility roster to demonstrate what is needed to maintain a compliant roster. Licensee will send analyst an updated roster, either changing the documenation on hers or using licensing's form, by 11/24/25 to correct the deficiency.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Jason Garay
NAME OF LICENSING PROGRAM MANAGER:
Luigi Gargaro
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 11/19/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/19/2025


LIC809 (FAS) - (06/04)
Page: 8 of 10
Document Has Been Signed on 11/19/2025 02:47 PM - It Cannot Be Edited


Created By: Luigi Gargaro On 11/19/2025 at 12:06 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: SAID, FADUMA FAMILY CHILD CARE
FACILITY NUMBER: 376629503

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/19/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102425(c)
Infant Safe Sleep
An Individual Infant Sleeping Plan [LIC 9227 (3/20)] shall be completed for each infant up to 12 months of age the provider has in care and included in the infant's file at the facility.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on analyst record review, the licensee did not comply with the section cited above as she did not have an Individual Infant Sleeping plan which poses/posed a potential health, safety or personal rights risk to infants in care.
POC Due Date: 11/24/2025
Plan of Correction
1
2
3
4
Analyst printed out a copy of the form for licensee to provide to the child's parent to complete and then submit a copy of the form to analyst by 11/24/25 to correct the deficiency.
Section Cited
Deficient Practice Statement
1
2
3
4
POC Due Date:
Plan of Correction
1
2
3
4
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Jason Garay
NAME OF LICENSING PROGRAM MANAGER:
Luigi Gargaro
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 11/19/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/19/2025


LIC809 (FAS) - (06/04)
Page: 9 of 10
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: SAID, FADUMA FAMILY CHILD CARE
FACILITY NUMBER: 376629503
VISIT DATE: 11/19/2025
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Licensee’s First Aid and CPR certifications have expired. Licensee has required immunizations but assisting family members do not have them on file. Licensee and assistant do not have current Mandated Reporter Training certifications. Facility roster is maintained and was reviewed but does not meet regulation requirements. The last fire and disaster drills were conducted and documented on 08/15/25 and 07/10/25, respectively. There is one crib or play yard for each infant who is unable to climb out of the crib or play yard but it was not fully available for use today. Cribs or play yards are free from all loose articles and objects. The provider physically checks on sleeping infants every 15 minutes but is not correctly maintaining a safe sleep log. An Individual Infant Sleeping Plan [LIC 9227 (3/20)] is not maintained for each infant up to 12 months of age. The provider places infants up to 12 months of age on their backs for sleeping.

LPA provided and discussed the following: Report suspected child abuse and neglect, maintain children’s records according to regulation, post all required forms, and ensure that all adults residing or working in the home have criminal background clearances or exemptions. Licensee was reminded that corporal punishment, smoking, exersaucers, bouncy seats, walkers, and jumpers and/or similar equipment are not allowed in daycare. Licensee was also provided handouts with information regarding upcoming Safe Sleep Regulations/SIDS, Lead exposure and Shaken Baby Syndrome. LPA and Licensee discussed California Megan's Law and LPA provided: www.meganslaw.ca.gov.

LPA discussed and provided Licensee with the following: child care advocates email address: childcareadvocatesprogram@dss.ca.gov. In addition, for general questions or questions regarding licensing requirements contact the Child Care Licensing Duty Line at (619) 767-2248. Unusual Incident Reports may be e-mailed to: SDIncidentReports@dss.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, 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.

Thirteen type B violations California Code of Regulations, (Title 22, Division 12 & Chapter 3), are being cited on the attached LIC 809-D.

An exit interview was conducted with the licensee. The licensee was provided a copy of their appeal rights (LIC 9058 12/15) and their signature on this form acknowledges receipt of these rights.

A notice of site visit was provided by the LPA and must remain posted for 30 days.
NAME OF LICENSING PROGRAM MANAGER: Jason Garay
NAME OF LICENSING PROGRAM ANALYST: Luigi Gargaro
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 11/19/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/19/2025
LIC809 (FAS) - (06/04)
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