Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376627417
Report Date: 05/03/2018
Date Signed: 05/08/2018 10:57:48 AM

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:HAMMO, SALI FAMILY CHILD CAREFACILITY NUMBER:
376627417
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: DATE:
05/03/2018
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
10:37 AM
MET WITH:Sali HammoTIME COMPLETED:
11:25 AM
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Licensing Program Analyst (LPA) Michelle Hood made an unannounced inspection for the purpose of an increase in capacity. LPA met with Licensee Sali Hammo. During the inspection there were no children in care.

On 04/30/18, a fire clearance was approved for 14 children. This two story 3 bedroom and 2.5 bathroom home was inspected. Licensee is using the following areas for day care: living room, half bathroom, kitchen, dining room, back patio, and upstairs bedroom 2. Off limits areas: master bed/bath room and bedroom 3. The off limits areas are made inaccessible to day care children through the use of door knob covers, door locks and safety gates. There is a sufficient amount of age appropriate toys, games, and books available. The home was clean and orderly, with comfortable temperature and ventilation for safety and comfort during the inspection. The fire extinguisher is rated 2-A;40;BC and located in the kitchen, smoke alarm and carbon monoxide detector are operational. There is a working telephone in the home and all required forms are posted. Licensee stated that there are NO firearms or ammunition on the property. All adults living or working in the home have been fingerprint cleared and associated. LPA reviewed children's files, child care roster, and emergency drill log. Last fire/disaster drill was conducted 02/20/18. Licensee Pediatric CPR and First Aid certification expire 09/2019.


LPA reviewed the following with licensee: SIDS, car seat law, reporting requirements, shaken baby syndrome and care and supervision. Licensee was also reminded the following items are prohibited during day care operating hours (walkers, exersaucers, jumpers and bouncy seats). Corporal punishment and smoking are not allowed in the day care.

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.
SUPERVISOR'S NAME: Carl SheltonTELEPHONE: (619) 767-2205
LICENSING EVALUATOR NAME: Michelle HoodTELEPHONE: (619) 767-2241
LICENSING EVALUATOR SIGNATURE:

DATE: 05/08/2018
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/08/2018
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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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: HAMMO, SALI FAMILY CHILD CARE
FACILITY NUMBER: 376627417
VISIT DATE: 05/03/2018
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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.html

Immunization records per SB792 were reviewed and are in compliance for Licensee.

The maximum capacity for a large family child care home: 12 children (with a qualified assistant) with no more than 4 infants; or (with landlord consent) 14 children (with a qualified assistant) with no more than 3 infants, 1 child enrolled in kindergarten or elementary school and 1 child at least age 6 including children under age 10 who live in the licensee's home. When there is no Qualified Assistant, 14 years of age or present, the capacity reverts back to the requirements for a Small Family Child Care. To access our Regulations and Forms please use our WEBSITE: http://ccld.ca.gov.

A Regular Large Family Child Care Home license maybe issued for 14 children upon final file review.
SUPERVISOR'S NAME: Carl SheltonTELEPHONE: (619) 767-2205
LICENSING EVALUATOR NAME: Michelle HoodTELEPHONE: (619) 767-2241
LICENSING EVALUATOR SIGNATURE:

DATE: 05/08/2018
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/08/2018
LIC809 (FAS) - (06/04)
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