384005203-8-12-2026-05-CC-CQUO-DWVV3Y-20260812160530

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 384005203
Report Date: 08/12/2026
Date Signed: 08/12/2026 04:05:48 PM

Document Has Been Signed on 08/12/2026 04:05 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 BRUNO CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME:	HIBA ACADEMY BAY AREA		FACILITY NUMBER:	384005203
ADMINISTRATOR/ DIRECTOR:	TARIQ HASSOUN		FACILITY TYPE:	860
ADDRESS:	99 RHODE ISLAND STREET		TELEPHONE:	(415) 930-0165
CITY:	SAN FRANCISCO	STATE: CA	ZIP CODE:	94103
CAPACITY: 144	TOTAL ENROLLED CHILDREN: 0	CENSUS: 0	DATE:	08/12/2026
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	09:00 AM
MET WITH:	Colette McWilliams		TIME VISIT/ INSPECTION COMPLETED:	04:30 PM

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 August 12, 2026 at approximately 9:00am, Licensing Program Analysts (LPAs) Quimbo and Alvarado conducted a scheduled, pre-licensing visit. LPAs met with applicant, Colette McWilliams, and explained the purpose of the visit. This is an initial application. Application was submitted April 13, 2026. Applicant originally requested for a total capacity of 144 children: 72 preschool children and 72 school age children. Fire clearance for 144 children: 72 preschool and 72 school age children was received August 3, 2026. Applicant updated their request for 144 preschool children (ages 3 years to 4 years old). Updated fire clearance with the updated component will be requested. The facility will operate Monday through Friday 8:30am to 3:30pm. There will be extended hours from 7:30am to 6:00pm. Facility is a multi-level facility (three levels) with preschool operations occurring on the ground level only. The second and third level will be for a private elementary school. The preschool program will operate in 11 classrooms: Multi-purpose #110 ("Wow" room), #101, #102, #103, #104, #105, #106, #107, #108, #116 (Art room), #121 (Library). Preschool program will also utilize the open space with teacher lead activity, multi-purpose indoor area outside the classrooms (open space with stage), and the outdoor area. LPAs inspected day care areas for health and safety hazards and measured day care areas. Preschool Indoor measurements are: The indoor area contains a total of 8,479.609 square feet which will accommodate applicant's request for 144 preschool children. (Continue report on page 2...)

Marie Rodriguez
Catrina Quimbo
	DATE: 08/12/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/12/2026

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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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)

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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
SAN BRUNO CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: HIBA ACADEMY BAY AREA	FACILITY NUMBER: 384005203
	VISIT DATE: 08/12/2026

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Preschool Outdoor measurements are:
There is 1 outdoor area for the preschool component. The outdoor area contains a total of 8,588.652 square feet which will not accommodate applicant's request for 144 preschool children. Outdoor area will also be shared with the private elementary school on a rotation schedule. Applicant will submit an outdoor rotation waiver request.

Preschool sinks and toilets:
There are 12 sinks and 12 toilets available for preschools' use. Toilet and sink ratio is sufficient to accommodate applicant's request for 144 preschool children.

The child care center was observed to be clean, sanitary and in good repair. A comfortable temperature for children is being maintained. Furniture and equipment were observed to be maintained in good condition. Tables and chairs are age-appropriate. There are rugs in the classroom that were observed to be clean and free of stains. LPAs observed lofts in classrooms that sustain the weight of an adult. LPAs advised applicant to be cautious of stairs leading to loft. Electrical outlets in classrooms were observed to have internal child proof locks. Per applicant, poisons and cleaning solutions will be stored in classrooms' high shelves, inaccessible to children.

LPAs observed children's restrooms to be in working condition. There are garbage bins with tight fitting lids throughout the facility. Sinks accessible to children do not provide water that is warmer than 120 degrees Fahrenheit. LPAs advised for hot water that is accessible to children to be turned off.

Preschool children will sleep in their classrooms on cots. Sheets and blankets will be provided by children's families and will be sent home weekly for laundering. Per applicant, cots will be sanitized weekly or as needed. Sheets and blankets will be stored in children's cubbies so that they are not touching each other. There is sufficient storage for children's belongings throughout the facility.

Facility includes a health room for sick children who may need to be isolated. LPAs reminded applicant children must always be supervised. Health room includes multiple, fully stocked first aid kits and emergency supplies. Facility is equipped with multiple fire extinguishers, fire sprinklers, smoke alarm, smoke detectors, and carbon monoxide detectors. A carbon monoxide detector was tested during today's visit and was observed to be in working condition. When medications are on site, they will be stored in a locked box that will be located in the classroom the child is enrolled in. There are refrigerators on site for medication, if needed.
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NAME OF LICENSING PROGRAM MANAGER: Marie Rodriguez
NAME OF LICENSING PROGRAM ANALYST: Catrina Quimbo
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 08/12/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/12/2026

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
SAN BRUNO CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: HIBA ACADEMY BAY AREA	FACILITY NUMBER: 384005203
	VISIT DATE: 08/12/2026

NARRATIVE

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This facility plans to provide Incidental Medical Services – IMS. For IMS information, see PIN 22-02-CCP. A Plan of Operation that includes 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) or (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

Licensing documents were posted in the hallway of the facility. Children will be signed in and out of program with written signatures. Per applicant, sign in and out sheets will be maintained for 30 days, and will be made available for review.

Outdoor area is fully enclosed and fenced. There is sufficient shade, if needed. Preschool area includes a play structure that sustains the weight of an adult. There is also a climbing wall in the outdoor area. LPAs observed resilient padding underneath the play structure and climbing wall. Labeling on children's play structure and climbing wall is designated for children ages 2 years to 5 years old. LPAs did not observe any pools, spas or other bodies of water on site.

Program will provide a food service that includes dry snacks only. There will be an option of a lunch service through a third party vendor that will cook and deliver food to the facility, daily. Per applicant, disposable utensils and materials will be utilized. There are accessible drinking fountains for children, when needed.

For child care center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1-CCP). Per applicant, lead testing has been completed July 2026. Applicant provided LPA with copies of LIC9275, LIC9276, and LIC999.

LPA reviewed with applicant , the LIC 311A, Records to Be Maintained at The Facility, for child’s records, personnel records, administrative records, and documents to be posted.

Applicant was informed of the MyChildCarePlan.org site, a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.
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NAME OF LICENSING PROGRAM MANAGER: Marie Rodriguez
NAME OF LICENSING PROGRAM ANALYST: Catrina Quimbo
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 08/12/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/12/2026

LIC809 (FAS) - (06/04)

Page: 4 of 5

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BRUNO CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: HIBA ACADEMY BAY AREA	FACILITY NUMBER: 384005203
	VISIT DATE: 08/12/2026

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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 athttps://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication

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

Applicant was reminded that all adults 18 and over responsible for administration or direct supervision of staff, persons who provides care and supervision to children, and staff who have contact with children, 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 Child Care Center. 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.

Facility will be approved for a total capacity of 144 preschool children (ages 3 to 4 years old) when following is complete:
-Updated fire clearance with updated component request.
-Submission of outdoor rotation waiver request.
-Management approval of outdoor rotation waiver.
-Centralized Application Bureau (CAB) final approval of application.

Exit interview conducted and report was reviewed with the applicant, Colette McWilliams.

NAME OF LICENSING PROGRAM MANAGER: Marie Rodriguez
NAME OF LICENSING PROGRAM ANALYST: Catrina Quimbo
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 08/12/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/12/2026

LIC809 (FAS) - (06/04)

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