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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013416719
Report Date: 03/18/2022
Date Signed: 03/18/2022 02:49:13 PM

Document Has Been Signed on 03/18/2022 02:49 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
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME:ABDELHALIM, GAMILAFACILITY NUMBER:
013416719
ADMINISTRATOR:ABDELHALIM, GAMILAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(510) 377-3444
CITY:FREMONTSTATE: CAZIP CODE:
94536
CAPACITY: 14TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
03/18/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
11:53 AM
MET WITH:Gamila AbdelhalimTIME COMPLETED:
12:30 PM
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On March 18, 2022 at approximately 11:55am Licensing Program Analyst Russ Haderer stopped by at licensee's home to check on the expired Inactive Status.

LPA had sent reminder letters on October 5th and a certified letter October 26th 2021 (confirmation of delivery received) asking licensee for an update and/or fill out LIC9211 for renewal of inactive status. No response came so on November 30, 2021, LPA called and left a message, followed by an email that same day asking for a response. Again, no response came.

On March 18, 2022 LPA drove to licensee's home for a follow up and met with the licensee in her driveway. LPA and licensee discussed the expired Inactive Status. Licensee filled out the LIC9211 Request for Inactive Status form requesting the inactive status be renewed for 1 year (through 11/4/2022).

Licensee also expressed interest in possibly opening a child care center in Oakland in the future. LPA suggested she check the CDSS website for information on opening a center and that she could also take the Child Care Center Orientation session, similar to the one she took for operating a childcare in her home..

LPA asked licensee to stay in communication with him regarding any change in her status. If and when she wishes to reopen, licensee must have everything up to date including: CPR/1st Aid; Mandated Reporter; Lead Poisoning Prevention certificate.

LPA documented the visit (in this form) and printed out a Site Visit form and left it with the licensee.
SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Russell Haderer
LICENSING EVALUATOR SIGNATURE: DATE: 03/18/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/18/2022
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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