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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376701400
Report Date: 01/28/2025
Date Signed: 01/28/2025 04:28:57 PM

Document Has Been Signed on 01/28/2025 04:28 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
SAN DIEGO N. CC RO, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME:MEDINA LEARNING CENTERFACILITY NUMBER:
376701400
ADMINISTRATOR/
DIRECTOR:		ANAB HADEFACILITY TYPE:
850
ADDRESS:6064 UNIVERSITY AVENUETELEPHONE:
(619) 906-4177
CITY:SAN DIEGOSTATE: CAZIP CODE:
92115
CAPACITY: 39TOTAL ENROLLED CHILDREN: 9CENSUS: 9DATE:
01/28/2025
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
04:00 PM
MET WITH:Izhar MohamedTIME VISIT/
INSPECTION COMPLETED:
04:45 PM
NARRATIVE
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On 1/28/25 at 4:00 pm, Licensing Program Analyst (LPA) Gerald Poindexter conducted an unannounced case management inspection while at the facility on another matter. LPA observed 9 preschool children present with the director, a teacher, and aide, also present. Facility is within ratio.

LPA met with Director Izhar Mohamed and discussed new employee, S1, who was described as a qualified teacher working as an aide until her overseas teacher credentials are cleared. LPA reviewed the personnel file for S1 and found it to be incomplete and missing required documentation.


See LIC 809D for deficiencies cited.

Exit interview conducted and report was reviewed with Izhar Mohamed. A Notice of Site Visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100. Appeal rights were provided.
SUPERVISORS NAME: Joelle Redding
LICENSING EVALUATOR NAME: Gerald Poindexter
LICENSING EVALUATOR SIGNATURE: DATE: 01/28/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/28/2025
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 3
Document Has Been Signed on 01/28/2025 04:28 PM - It Cannot Be Edited


Created By: Gerald Poindexter On 01/28/2025 at 04:02 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: MEDINA LEARNING CENTER
FACILITY NUMBER: 376701400

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/28/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/11/2025
Section Cited
CCR
101216(g)(2)

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Personnel Requirements: (2) Each person specified in (g) above shall have a health-screening report signed by the person performing the screening. This report shall indicate the following: This requirement is not met as evidenced by:
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Director stated she will submit proof of missing documents to the Department by 2/11/25. Email: Gerald.Poindexter@dss.ca.gov
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Based on records review, staff, S1 was missing a completed LIC 503 Health Screening or equivelent in their records, which poses/posed a potential health, safety or personal rights risk to persons in care.
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Type B
02/11/2025
Section Cited
HSC1596.7995

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ยง1596.7995 (a) (1) a person shall not be employed or volunteer at a day care center if he or she has not been immunized against influenza, pertussis, and measles.
This requirement is not met as evidenced by:
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Director stated she will provided proof of missing immunizations to the Department by 2/11/25. Email: Gerald.Poindexter@dss.ca.gov
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Based on records review staff S1 did not have full immunizations proof in their file which poses/posed a potential health, safety or personal rights risk to persons 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:Joelle Redding
LICENSING EVALUATOR NAME:Gerald Poindexter
LICENSING EVALUATOR SIGNATURE:
DATE: 01/28/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/28/2025


LIC809 (FAS) - (06/04)
Page: 2 of 3
Document Has Been Signed on 01/28/2025 04:28 PM - It Cannot Be Edited


Created By: Gerald Poindexter On 01/28/2025 at 04:10 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: MEDINA LEARNING CENTER
FACILITY NUMBER: 376701400

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/28/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/11/2025
Section Cited
HSC
1596.8662(b)(1)

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(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:
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Director stated that staff S1 will complete the Mandated Reporter training and submit certificate of traning no later than 2/11/25.
Email: Gerald.Poindexter@dss.ca.gov
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Based on record review, the licensee did not comply with the section cited above. Staff S1 was missing Mandated Reporter Training on file. This poses a potential health, safety or personal rights risk to persons 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:Joelle Redding
LICENSING EVALUATOR NAME:Gerald Poindexter
LICENSING EVALUATOR SIGNATURE:
DATE: 01/28/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/28/2025


LIC809 (FAS) - (06/04)
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