Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376623205
Report Date: 04/03/2018
Date Signed: 04/03/2018 03:31:10 PM

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:MOHAMOUD, FARDOS FAMILY CHILD CAREFACILITY NUMBER:
376623205
ADMINISTRATOR:FARDOS MOHAMOUDFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(619) 795-7507
CITY:SAN DIEGOSTATE: CAZIP CODE:
92105
CAPACITY:14CENSUS: 5DATE:
04/03/2018
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
01:45 PM
MET WITH:Fardos MohamoudTIME COMPLETED:
03:45 PM
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LPA, Luigi Gargaro, conducted an unannounced inspection with the licensee. The town home was toured and inspected to ensure an environment safe for the care and supervision of children per the standards established in CCR, Title 22, Division 12, Chapter 3, for Family Child Care Homes. Present was the licensee and five day care children. The fire extinguisher and combination smoke and carbon monoxide detector meet requirements and are operational. All hazardous items were latched/locked and secured out of reach of children. There are no bodies of water or weapons in the home. A review of staff records on this date indicates that all adults or other individuals who require caregiver background checks have received criminal record and child abuse clearances or exemptions. First Aid and CPR certifications expire on April of 2019 for the licensee and January of 2020 for her helper son, Mohamed Mohamed. Children’s records were reviewed and found to be in order.

Licensee has provided adequate space for the children to eat, sleep and play within the home. Areas used for child care include the kitchen, the living room, the dining area and the bathroom. Off limits areas include the entire upstairs and is inaccessible through use of an installed safety gate at the bottom of the home staircase. The licensee also has a back patio area that leads out into the neighborhood street that is also off limits. It is made that way with a bolt lock. The licensee has sufficient toys and equipment available. Licensee's complex has a facility playground that the provider uses for outdoor activities. Licensee was reminded that whenever she takes the children to the playground for outdoor play she must always provide direct supervision as the playground is in an area that is shared by all the tenants in the complex and she must always monitor them to ensure their health and safety.

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.

No violations were cited today as the home appeared to be in substantial compliance.
SUPERVISOR'S NAME: Carl SheltonTELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: Luigi GargaroTELEPHONE: (619) 767-2229
LICENSING EVALUATOR SIGNATURE:

DATE: 04/03/2018
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/03/2018
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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