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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376630090
Report Date: 09/05/2024
Date Signed: 09/05/2024 10:25:27 AM

Document Has Been Signed on 09/05/2024 10:25 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
CCLD Regional Office, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME:ALAWAD, MAZIN FAMILY CHILD CAREFACILITY NUMBER:
376630090
ADMINISTRATOR/
DIRECTOR:		MAZIN ALAWADFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(760) 412-9006
CITY:SAN DIEGOSTATE: CAZIP CODE:
92105
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 0DATE:
09/05/2024
TYPE OF VISIT:PrelicensingANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
07:30 AM
MET WITH:Mazin AlawadTIME VISIT/
INSPECTION COMPLETED:
09:45 AM
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On September 5, 2024, at 7:30 AM, Licensing Program Analyst (LPA) Jo Ann Legaspi conducted a pre-licensing relocation inspection with Applicant Mazin Alawad. The inspection’s purpose is to ensure that the home follows standards established in CCR, Title 22, Division 12, Chapter 3, for Family Childcare Homes. Present in the home was only the Applicant. This two (2) bedroom, one (1) bathroom, single floored house was toured and inspected. During this inspection, applicant completed another LIC 279 Application form to reflect the proposed daycare’s operating schedule. The daycare operational schedule will be weekdays 1:30 PM to 12 AM and on the weekends 7 AM to 10 PM. The Applicant shall submit an updated application to the Licensing Department should the daycare operational schedule change.

The Applicant acknowledges that they will need to notify the Department of any changes to the childcare areas and obtain departmental approval before use of any new childcare areas not previously inspected. Applicant will use the following areas for childcare: the living room, the bathroom, shaded patio and upper backyard. The off-limits areas include the master bedroom, hallway closet, kitchen, and lower backyard. Child safety doorknob covers are on the doorknobs to the master bedroom and hallway closet. The gates to the lower backyard and the patio towards the unit in front of the proposed facility do not have gate locks. The fire extinguisher is rated 2A 10B: C. and is in the kitchen. The smoke and carbon monoxide detectors met requirements and are operational. The Fire Safety Inspection Request (STD 850) was approved by the local fire marshal on 08/15/2024 for fourteen (14) children. Written substantiation that the applicant has at least one year of experience as a regulated small family childcare home operator has been obtained.

Poisons, detergents, and cleaning compounds are secured inaccessible to children in care by placement in a locked kitchen undersink cabinet. Applicant states there are no medications in the home. Children’s toys and play equipment are available. The Applicant has a working telephone/cell phone. The Applicant shall notify licensing should their telephone number or email address ever change. The Applicant said there are no
SUPERVISORS NAME: Tulam Vu
LICENSING EVALUATOR NAME: JoAnn R Legaspi
LICENSING EVALUATOR SIGNATURE: DATE: 09/05/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/05/2024
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: ALAWAD, MAZIN FAMILY CHILD CARE
FACILITY NUMBER: 376630090
VISIT DATE: 09/05/2024
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firearms or other weapons in the home. An empty pigeon coop is located in the upper backyard. Applicant states that when the proposed facility is licensed, pigeons will be moved to this pigeon coop. Applicant reported there are no bodies of water, and none were observed during time of visit.

The Applicant intends to conduct outdoor activities in the shaded patio, upper backyard and/or a neighborhood park. The Applicant acknowledges continuous, visual supervision shall be given whenever children are engaged in outdoor activities. The Applicant may transport the children in their own vehicle if legally licensed and the vehicle lawfully insured. The Applicant shall transport children in rear seats in appropriate child passenger restraint systems which meet applicable federal motor vehicle safety standards. The Applicant acknowledges that car seats shall only be used for transportation purposes and shall not be used for sleeping. The Applicant acknowledges children shall never be left unattended in the daycare vehicle. The Applicant states they will adhere to the daycare vehicle’s safety maintenance schedule and promptly address any vehicular issues to ensure children’s safety.

Applicant has completed the preventative health and lead poisoning prevention courses. The Mandated Reporter training was completed on 08/15/2024. Applicant acknowledges they will need to repeat the Mandated Reporter training and obtain its training completion certificate once every two (2) years. Pediatric CPR and First Aid certifications expire in August 2026. Applicant acknowledges that they will need to repeat the pediatric CPR and First Aide certifications before August 2026. Immunization records per SB792 were reviewed and comply. Applicant acknowledges they will either receive a yearly influenza vaccination or have a yearly written statement declining receipt of the annual influenza vaccination. Applicant shall maintain written documentation of the yearly influenza vaccination or yearly written statement declining the annual influenza vaccination in the facility file available for Departmental review.

Applicant was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated. The Applicant was advised that any new/additional adults must be cleared prior to working or residing in home. Any minor upon their 18th birthday must be fingerprinted within 30 days.

SUPERVISORS NAME: Tulam Vu
LICENSING EVALUATOR NAME: JoAnn R Legaspi
LICENSING EVALUATOR SIGNATURE:

DATE: 09/05/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/05/2024
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: ALAWAD, MAZIN FAMILY CHILD CARE
FACILITY NUMBER: 376630090
VISIT DATE: 09/05/2024
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The Applicant provided proof of control of property. Because the applicant rents/leases the home, proof of landlord notification is required. The LPA observed the Property Owner/Landlord Notification form (LIC9151) that the applicant confirms was provided to the property owner/landlord. The applicant obtained a signed Property Owner/Landlord Consent form (LIC 9149).

The Applicant was provided with the Ratio/Capacity Worksheet for a large family childcare home. The Applicant recognizes that the total amount of children simultaneously in the home also includes children who reside in the home. The Applicant acknowledged that if no fully qualified helper is present at a Large Family Childcare Home, then the Applicant shall comply with the capacity requirements for a Small Family Childcare Home and not care for more than eight (8) children.

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 Applicant shall ensure at least one staff member has a current course completion card in pediatric first aid and pediatric CPR issued and Mandated Reporter Training certificate, unless the Mandated Reporter training is exempted by the Department. 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.

Applicant acknowledges that they will obtain and maintain written evidence of the potential helper’s current tuberculosis clearance, not more than one year prior to or seven days after initial presence in the home before their initial presence in a family childcare home. The Applicant shall not employ a staff member if they have not been immunized against influenza, pertussis, and measles. 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 and any annual written statements declining receipt of the yearly influenza vaccination shall be maintained in the staff’s facility personnel record available for review by the Department. The Applicant 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 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.

SUPERVISORS NAME: Tulam Vu
LICENSING EVALUATOR NAME: JoAnn R Legaspi
LICENSING EVALUATOR SIGNATURE:

DATE: 09/05/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/05/2024
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: ALAWAD, MAZIN FAMILY CHILD CARE
FACILITY NUMBER: 376630090
VISIT DATE: 09/05/2024
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The Applicant acknowledges that the definition of a Family Day Care means regularly provided care, protection, and supervision of children, in the care giver's own home.

The Applicant acknowledges that licensees shall be present in their home and shall ensure that children in care are supervised at all times. Applicant also acknowledged that when circumstances require a licensee to be temporarily absent from the home, the licensee shall arrange for a substitute adult, who is background cleared and associated to the license, to care for and supervise the children during their absence. Applicant


acknowledged that temporary absences shall not exceed 20 percent of the hours that the facility is providing care per day.

During the interview, the Applicant, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS. On this date, 08/05/2024, the California Attorney General - Megan’s Law website was searched for information on sex offenders required to register with local law enforcement under California's Megan's Law. No registered sex offenders were found at the facility address. Under state law, some registered sex offenders are not subject to public disclosure; therefore, they may not have been included in this search. However, the Department conducts a monthly cross reference of each address on record for all registered sex offenders against all CCLD facility addresses pursuant to information shared by California DOJ.

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 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.

LPA discussed the safe sleep regulations with applicant and discussed the Childcare Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed applicant 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
SUPERVISORS NAME: Tulam Vu
LICENSING EVALUATOR NAME: JoAnn R Legaspi
LICENSING EVALUATOR SIGNATURE:

DATE: 09/05/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/05/2024
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: ALAWAD, MAZIN FAMILY CHILD CARE
FACILITY NUMBER: 376630090
VISIT DATE: 09/05/2024
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recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. 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: https://www.ada.gov/resources/child-care-centers/.

LPA reviewed with Applicant the LIC 311D, Forms/Records to Keep in Your Family Childcare Homes, children’s forms/records, facility forms/records, and information to be posted. Applicant acknowledges they will maintain all facility postings, individual child files and staff/licensee files available for licensing review. Entrance Checklist was provided to the applicant. The Applicant was also informed the following items are prohibited during day care operating hours: walkers, exersaucers, jumpers, inclined sleepers, and bouncy seats. Corporal punishment and smoking are not allowed in the day care.

The Applicant states they are financially secure to operate a family childcare home for children. The Applicant agrees to comply with all regulations and laws governing family childcare homes.



Applicant was advised that any agent of the Licensing Department upon presentation of proper identification, may enter and inspect any place providing personal care, supervision, and services at any time, with or without advance notice. The Applicant shall permit the Department to inspect the family childcare home, and to privately interview children or adults, to determine compliance with or to prevent violations of family childcare laws or regulations. Applicant was advised that the Department shall assess an immediate civil penalty of five hundred dollars ($500) per violation and one hundred dollars ($100) for each day the violation continues after citation, if the Applicant refuses any agent of the licensing Department entry into the daycare or any part of the daycare.

LPA informed Applicant that the failure of a Licensee to pay all applicable and accrued fees and/or civil penalties shall constitute grounds of forfeiture of the daycare license.

Applicant was informed of the MyChildCarePlan.org website; a consumer education website that helps

SUPERVISORS NAME: Tulam Vu
LICENSING EVALUATOR NAME: JoAnn R Legaspi
LICENSING EVALUATOR SIGNATURE:

DATE: 09/05/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/05/2024
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: ALAWAD, MAZIN FAMILY CHILD CARE
FACILITY NUMBER: 376630090
VISIT DATE: 09/05/2024
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families obtain childcare by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California.

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 Childcare option to receive email communication. Applicant’s email address is already enrolled into the Department’s email program update notification system.

The following corrections are needed:

· Lock on Gate Door To Lower Backyard Area

· Lock on Gate Door to The Front Unit Located in the Patio Area,

A large family childcare home license may be issued upon receipt of confirmation of the completed corrections and a final file review. Exit interview conducted and report was reviewed with the Applicant Mazin Alawad.

To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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.

SUPERVISORS NAME: Tulam Vu
LICENSING EVALUATOR NAME: JoAnn R Legaspi
LICENSING EVALUATOR SIGNATURE:

DATE: 09/05/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/05/2024
LIC809 (FAS) - (06/04)
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