376629958-7-15-2024-20-CC-JARL-D77QTK-20240715122712

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 376629958
Report Date: 07/15/2024
Date Signed: 07/15/2024 12:27:21 PM

Document Has Been Signed on 07/15/2024 12:27 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:	FARAH, ASHA FAMILY CHILD CARE		FACILITY NUMBER:	376629958
ADMINISTRATOR/ DIRECTOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 8	CENSUS: 0	DATE:	07/15/2024
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	10:45 AM
MET WITH:	Asha Farah		TIME VISIT/ INSPECTION COMPLETED:	11:30 AM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	On July 15, 2024 at 10:45 AM, Licensing Program Analyst (LPA), Jo Ann Legaspi conducted an unannounced capacity increase inspection. Licensee Asha Farah was advised of the meeting’s purpose and granted LPA facility entry. Present in the home was only the Licensee. On 06/10/2024, Licensee submitted an application (LIC 279) requesting a capacity increase. The Fire Safety Inspection Request (STD 850) was approved by the local fire marshal on 06/10/2024 for fourteen (14) children. Landlord Consent is on file. The Licensee has provided written substantiation that they have at least one year of experience as a regulated small family child care home operator. This two (2) bedroom, one (1) bathroom downstairs apartment unit was toured and inspected. The following areas will be used for childcare: the living room, dining room, bathroom and the fenced backyard. The off-limits areas include the kitchen and bedrooms. Bedroom doorknobs are covered with child safety doorknob covers. Cabinet locks are on kitchen cabinets. Licensee accompanied LPA on a tour of the home, as shown on the updated facility sketch. Background criminal record clearances were verified and discussed. First Aid and CPR certifications expire in April 2026. Facility has working 2A10BC fire extinguisher, smoke alarms, carbon monoxide, and the first aid kit in place. The last safety drill was on 06/11/2024. An in-ground pool and spa are on the property. Both are surrounded with a fence, which is at least five feet high, and does not obscure the pool and spa from view. The pool and spa gates swings away from the pool and spa. Applicant states that the pool and spa gates are locked with a fence door lock. Applicant declared children will not play in this pool and the keys to the pool will be stored in a locked cabinet whenever daycare children are present. The Licensee states neither animals/pets nor firearms/ammunition are housed in the facility. The daycare schedule is everyday 5 AM to 4 AM. To provide overnight care, the applicant shall remain awake whenever children are awake. The door to the room where the applicant is sleeping as well as the door to the room where the children in care are sleeping

SUPERVISORS NAME: Tulam Vu
LICENSING EVALUATOR NAME: JoAnn R Legaspi
LICENSING EVALUATOR SIGNATURE:	DATE: 07/15/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/15/2024

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
CCLD Regional Office, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108

FACILITY NAME: FARAH, ASHA FAMILY CHILD CARE	FACILITY NUMBER: 376629958
	VISIT DATE: 07/15/2024

NARRATIVE

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shall remain open. If the sleeping arrangements are not situated in such a way that the applicant can be assured of hearing a child in care wake up, a digital video and audio monitoring device shall be used; the monitoring device shall be maintained in good working order at all times. Clean bedding and nightclothes shall be available to children in care. To provide overnight care for infants, the provider shall the follow requirements specified in CCR 102425 Infant Safe Sleep Regulations.

The Licensee provided proof of control of property. Because the licensee rents/leases the home, proof of landlord notification is required. The LPA observed the Property Owner/Landlord Notification form (LIC9151) that the licensee confirms was provided to the property owner/landlord. The licensee obtained a signed Property Owner/Landlord Consent form (LIC 9149).

The Licensee was provided with the Ratio/Capacity Worksheet for a large family childcare home. The Licensee recognizes that the total amount of children simultaneously in the home also includes children who reside in the home. The Licensee acknowledged that if no assistant provider is present at a Large Family Child Care Home, then the Licensee shall comply with the capacity requirements for a Small Family Child Care Home.

Licensees of family day care homes shall ensure that at least one staff member shall always be onsite when children are present at the facility and shall be present with the children when children are offsite from the facility for facility activities. The Licensee shall ensure staff members have a current course completion card in pediatric first aid and pediatric CPR issued by the American Red Cross, the American Heart Association, or by a training program that has been approved by the Emergency Medical Services Authority. Prior to employment or initial presence in the childcare home, all employees subject to a criminal record review shall: obtain a California clearance or a criminal record exemption as required by law or Department regulations or request a transfer of a criminal record clearance. The Licensee shall not employ a staff member if they have not been immunized against influenza, pertussis, measles and tuberculosis. Each employee shall receive an influenza vaccination between August 1 and December 1 of each year. The employee may submit a yearly written declaration attesting that they have declined the influenza vaccination. This exemption applies only to the influenza vaccine. Documentation of immunizations is to be maintained in the staff’s facility personnel record. The Licensee shall provide each employee with a copy of the Notice of Employee Rights (LIC 9052) form furnished by the Department. Each employee shall be requested to sign and date the notice form

SUPERVISORS NAME: Tulam Vu
LICENSING EVALUATOR NAME: JoAnn R Legaspi
LICENSING EVALUATOR SIGNATURE:	DATE: 07/15/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/15/2024

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
CCLD Regional Office, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108

FACILITY NAME: FARAH, ASHA FAMILY CHILD CARE	FACILITY NUMBER: 376629958
	VISIT DATE: 07/15/2024

NARRATIVE

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acknowledging receipt. A copy of the signed notice form shall be retained in the employee's personnel record. If the employee refuses to sign the notice form, a dated notation to that effect shall be retained in the employee's personnel record.

The Licensee is advised to regularly visit the Community Care Licensing WEB SITE: http://www.ccld.ca.gov/ for quarterly updates and updated regulation information. 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 platforms. 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. LPA observed applicant’s email address is already enrolled into the Department’s email program update notification system; final enrollment is pending the applicant’s confirmation of their email via the link that was emailed to them by the Department. Information about the San Diego Licensing Duty Line was provided. The telephone number to the Licensing Duty Line is (619) 767-2248. Southern California Child Care Advocate (SCCCA) information was provided. Advocate information was provided: (916) 654-1541 and childcareadvocatesprogram@dss.ca.gov

In the areas that were evaluated, no deficiencies were observed. Licensure for a capacity of fourteen (14) of children is approved today (07/15/2024). Licensee requests to retrieve the new license from the licensing office when available. LPA will email applicant when the new license is available.

A notice of site visit was given to licensee and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days. Exit interview conducted and report was reviewed with the Licensee Asha Farah.

SUPERVISORS NAME: Tulam Vu
LICENSING EVALUATOR NAME: JoAnn R Legaspi
LICENSING EVALUATOR SIGNATURE:	DATE: 07/15/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/15/2024

LIC809 (FAS) - (06/04)

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