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Department of
SOCIAL SERVICES
Community Care Licensing
FACILITY EVALUATION REPORT
Facility Number:
376625397
Report Date:
10/03/2022
Date Signed:
10/03/2022 03:31:00 PM
Document Has Been Signed on
10/03/2022 03:31 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
,
7575 METROPOLITAN DR., STE 110
SAN DIEGO
,
CA
92108
FACILITY NAME:
SAID, FADUMA FAMILY CHILD CARE
FACILITY NUMBER:
376625397
ADMINISTRATOR:
FADUMA SAID
FACILITY TYPE:
810
ADDRESS:
TELEPHONE:
(619) 703-6015
CITY:
SAN DIEGO
STATE:
CA
ZIP CODE:
92105
CAPACITY:
14
TOTAL ENROLLED CHILDREN:
14
CENSUS:
0
DATE:
10/03/2022
TYPE OF VISIT:
Case Management - Annual Continuation
UNANNOUNCED
TIME BEGAN:
10:33 AM
MET WITH:
Faduma Said
TIME COMPLETED:
03:45 PM
NARRATIVE
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On
October 3, at 10:15
AM Licensing Program Analyst (LPA),
Luigi Gargaro conducted an unannounced
annual required inspection and met with the
licensee,
Faduma Said. Visit was an annual continuation visit from 09/21/22. LPA disclosed the purpose of the inspection and was granted entry into the facility by the licensee's helper, Asho Eymoy until licensee, who wasn't present at the start of the visit, arrived.
Four
children, assistant Eymoy and the licensee
were present in the facility during this inspection as well as Ms. Emyoy's three cleared and associated adult sons. This facility is a
one floor,
two
bedroom, one
bathroom
apartment
. Licensee accompanied LPA inside the facility during this inspection. The following areas used for child care are:
the kitchen, the living room, the two home bedrooms and the bathroom. The home has no off limits rooms.
The fire extinguisher and smoke detector met requirements. Most hazardous items were inaccessible to
children. The licensee has some day care equipment and materials available. The home does not have a backyard available for outdoor activities. Licensee takes children to a local park for outdoor activities instead. No bodies of water observed on the premises during the inspection.
Licensee stated there are no weapons in the home.
A review of staff records on this date indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse clearances or exemptions. Licensee’s First Aid and CPR certifications
are not from an EMSA approvied training provided.
Licensee and assistant did not have copies of their required immunizations today. Licensee did not have a current copy of her Mandated Reporter Training certification. Facility roster was reviewed and needs to be updated. The licensee states she has been conducting fire and disaster drills but has not been documenting them. There is not one crib or play yard for each infant who is unable to climb out of the crib or play yard.
The provider physically checks on sleeping infants every 15 minutes.
An Individual Infant Sleeping Plan [LIC 9227 (3/20)] is not maintained for each infant up to 12 months of age.
The provider places infants up to 12 months of age on their backs for sleeping.
SUPERVISORS NAME
:
Jason Garay
LICENSING EVALUATOR NAME
:
Luigi Gargaro
LICENSING EVALUATOR SIGNATURE
:
DATE:
10/03/2022
I acknowledge receipt of this form and understand my
licensing
appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
10/03/2022
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
11
Document Has Been Signed on
10/03/2022 03:31 PM
- It Cannot Be Edited
Created By:
Luigi Gargaro
On
10/03/2022
at
12:48 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:
SAID, FADUMA FAMILY CHILD CARE
FACILITY NUMBER:
376625397
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE:
10/03/2022
DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
102417(a)
Operation of A Family Child Care Home
(a) The licensee shall be present in the home and shall ensure that children in care are supervised at all times. When circumstances require the licensee to be temporarily absent from the home, the licensee shall arrange for a substitute adult to care for and supervise the children during his/her absence. Temporary absences shall not exceed 20 percent of the hours that the facility is providing care per day.
This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on analyst observation, the licensee did not comply with the section cited above as when analyst arrived at the facility he knocked on the door which was opened for him by the toddlers in care. Licensee was not present and after analyst called out several times, he saw helper Asho Eymoy pull off a blanket from a mattress on the floor on which she appeared to be sleeping.which poses/posed an immediate health, safety or personal rights risk to children in care
POC Due Date:
10/04/2022
Plan of Correction
1
2
3
4
Licensee understands that children in care must be supervised at all times and that her helper must always be actively supervising them. Licensee states she will discuss this with her assistant Ms. Eymoy and will provide LPA with a written statement signed by her and her assistant indicating that they understand the supervision requirements and will strictly adhere to them in the future. Licensee will submit signed statement to analyst by 10/04/22 to completee the correction.
Section Cited
Deficient Practice Statement
1
2
3
4
POC Due Date:
Plan of Correction
1
2
3
4
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:
Jason Garay
LICENSING EVALUATOR NAME:
Luigi Gargaro
LICENSING EVALUATOR SIGNATURE:
DATE:
10/03/2022
I acknowledge receipt of this form and understand my
appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
10/03/2022
LIC809
(FAS) - (06/04)
Page:
2
of
10
Document Has Been Signed on
10/03/2022 03:31 PM
- It Cannot Be Edited
Created By:
Luigi Gargaro
On
10/03/2022
at
12:48 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:
SAID, FADUMA FAMILY CHILD CARE
FACILITY NUMBER:
376625397
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE:
10/03/2022
DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1597.543
Licensure Requirements
Every family day care home for children shall have one or more carbon monoxide detectors in the facility that meet the standards established in Chapter 8 (commencing with Section 13260) of Part 2 Division 12. The department shall account for the presence of these detectors during inspections.
This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on analyst observation, the licensee did not comply with the section cited above as when he tested the home carbon monoxide detector it was not working which poses/posed a potential health, safety or personal rights risk to children in care.
POC Due Date:
10/06/2022
Plan of Correction
1
2
3
4
Licensee states the detector is sometimes inoperable and that she will purchase a new one and then send analyst a video recording demonstrating that she has an operating detector by 10/06/22 to complete the correction.
Section Cited
Definitions
Deficient Practice Statement
1
2
3
4
POC Due Date:
Plan of Correction
1
2
3
4
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:
Jason Garay
LICENSING EVALUATOR NAME:
Luigi Gargaro
LICENSING EVALUATOR SIGNATURE:
DATE:
10/03/2022
I acknowledge receipt of this form and understand my
appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
10/03/2022
LIC809
(FAS) - (06/04)
Page:
8
of
11
Document Has Been Signed on
10/03/2022 03:31 PM
- It Cannot Be Edited
Created By:
Luigi Gargaro
On
10/03/2022
at
12:48 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:
SAID, FADUMA FAMILY CHILD CARE
FACILITY NUMBER:
376625397
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE:
10/03/2022
DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102417(g)(4)
Operation of A Family Child Care Home
(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (4) Poisons, detergents, cleaning compounds, medicines, firearms and other items which could pose a danger if readily available to children shall be stored where they are inaccessible to children.
This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on observation, the licensee did not comply with the section cited above as analyst found toxics such as LA's Totally Awesome Cleaner, paint cans and hair gel in an unlatched bathroom cabinet and on top of the bathroom sink, respectively, which poses/posed a potential health, safety or personal rights risk to children in care.
POC Due Date:
10/03/2022
Plan of Correction
1
2
3
4
Licensee removed the items and placed them in an inaccessible area before analyst left the home today. Licensee understands that hazardous items shall always be made inaccessible by either having them kept in a high place that cannot be reached by children or having reachable cabinets or drawers latched or secured in any other way to make items inaccessible.
Section Cited
Deficient Practice Statement
1
2
3
4
POC Due Date:
Plan of Correction
1
2
3
4
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:
Jason Garay
LICENSING EVALUATOR NAME:
Luigi Gargaro
LICENSING EVALUATOR SIGNATURE:
DATE:
10/03/2022
I acknowledge receipt of this form and understand my
appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
10/03/2022
LIC809
(FAS) - (06/04)
Page:
3
of
11
Document Has Been Signed on
10/03/2022 03:31 PM
- It Cannot Be Edited
Created By:
Luigi Gargaro
On
10/03/2022
at
12:48 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:
SAID, FADUMA FAMILY CHILD CARE
FACILITY NUMBER:
376625397
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE:
10/03/2022
DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102417(g)(9)(A)1
Operation of A Family Child Care Home
(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (9) Each family child care home shall have a written disaster plan of action prepared on a form approved by the Department. All children, age and ability permitting, and the provider, the assistant provider, and other members of the household, shall be instructed in their duties under the disaster plan. As their age and ability permit, newly enrolled children shall be informed promptly of their duties as required in the plan. (A) Each family child care home shall conduct fire drills and disaster drills at least once every six months. 1. The licensee shall document the drills, including the date and time of each drill. This documentation shall kept at the family child care home.
This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on record review, the licensee did not comply with the section cited above as though she states she has conducted fire and disaster drills as required has not documented them which poses/posed a potential health, safety or personal rights risk to children in care.
POC Due Date:
10/06/2022
Plan of Correction
1
2
3
4
Licensee states she will update her disaster drill log and send analyst a copy of the completed drills and their dates by 10/06/22 to complete the correction.
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:
Jason Garay
LICENSING EVALUATOR NAME:
Luigi Gargaro
LICENSING EVALUATOR SIGNATURE:
DATE:
10/03/2022
I acknowledge receipt of this form and understand my
appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
10/03/2022
LIC809
(FAS) - (06/04)
Page:
9
of
11
Document Has Been Signed on
10/03/2022 03:31 PM
- It Cannot Be Edited
Created By:
Luigi Gargaro
On
10/03/2022
at
12:48 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:
SAID, FADUMA FAMILY CHILD CARE
FACILITY NUMBER:
376625397
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE:
10/03/2022
DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102425(a)
Infant Safe Sleep
(a) There shall be one crib or play yard for each infant who is unable to climb out of the crib or play yard.
This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on observation and interview, the licensee did not comply with the section cited above as she stated she did not have a play yard for child #! to nap in yet which poses/posed a potential health, safety or personal rights risk to children in care.
POC Due Date:
10/06/2022
Plan of Correction
1
2
3
4
Licensee states that the other infants she is caring for on weekends have their own play yards that their parents bring and take back home with them after coming to day care but that today's infant didn't have one. The licensee states she will have parent bring a play yard for the infant to nap in and send an analyst a photo by 10/06/22 to complete the correction.
Type B
Section Cited
CCR
102425(j)(2)(A)
Infant Safe Sleep
The provider shall supervise infants while they are sleeping and adhere to the following requirements: The provider shall check and document the following: Labored breathing.
This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on interview and record review, the licensee did not comply with the section cited above as she stated she has not maintained any type of sleep logs for infants in care which poses/posed a potential health, safety or personal rights risk to children in care.
POC Due Date:
10/17/2022
Plan of Correction
1
2
3
4
Licensee stated that was unaware of the safe sleep regulations for infants. Analyst provided the licensee with a copy of them and a sample safe sleep log today. Licensee will begin monitoring infants' napping times, including those of her weekend children, starting tomorrow 10/04//22 and continue to do so and then submit copies of the completed records for 10/04/22 to 10/17/22 for all four infants in care to analyst by 10/17/22 to complete the correction.
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:
Jason Garay
LICENSING EVALUATOR NAME:
Luigi Gargaro
LICENSING EVALUATOR SIGNATURE:
DATE:
10/03/2022
I acknowledge receipt of this form and understand my
appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
10/03/2022
LIC809
(FAS) - (06/04)
Page:
5
of
11
Document Has Been Signed on
10/03/2022 03:31 PM
- It Cannot Be Edited
Created By:
Luigi Gargaro
On
10/03/2022
at
12:48 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:
SAID, FADUMA FAMILY CHILD CARE
FACILITY NUMBER:
376625397
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE:
10/03/2022
DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1596.8662(b)(1)
Administration of Child Day Care Licensing
(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:
Deficient Practice Statement
1
2
3
4
Based on observation and record review, the licensee did not comply with the section cited above as she did not have a current Madated Reporter Training completion certificate which poses/posed a potential health, safety or personal rights risk to children in care.
POC Due Date:
11/07/2022
Plan of Correction
1
2
3
4
Licensee states she will take the required on-line training and submit a certificate of completion for it to analyst by 11/07/22 to correct the deficiency.
Type B
Section Cited
HSC
1597.622(c)
Administration of Child Day Care Licensing
(c) The family day care home shall maintain documentation of the required immunizations or exemptions from immunization, as set forth in this section, in the person's personnel record that is maintained by the family day care home.
This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on record review, the licensee and her assistant did not comply with the section cited above as neither had a copy of their records demonstrating receipt of the required immunizations for child care providers which poses/posed a potential health, safety or personal rights risk to children in care.
POC Due Date:
11/07/2022
Plan of Correction
1
2
3
4
Licensee was provided with a copy of the required immunizations needed for personnel caring for children and stated that she will obtain copies of her and her assistant's shot cards and submit a copy of them to analyst or obtain the required immunizations or documents proving immunity and submit them to analyst by 11/07/22 to complete the correction.
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:
Jason Garay
LICENSING EVALUATOR NAME:
Luigi Gargaro
LICENSING EVALUATOR SIGNATURE:
DATE:
10/03/2022
I acknowledge receipt of this form and understand my
appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
10/03/2022
LIC809
(FAS) - (06/04)
Page:
4
of
11
Document Has Been Signed on
10/03/2022 03:31 PM
- It Cannot Be Edited
Created By:
Luigi Gargaro
On
10/03/2022
at
12:48 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:
SAID, FADUMA FAMILY CHILD CARE
FACILITY NUMBER:
376625397
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE:
10/03/2022
DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102416(c)
Personnel Requirements
(c) The licensee and other personnel as specified shall complete training on preventive health practices, including pediatric cardiopulmonary resuscitation and pediatric first aid, pursuant to Health and Safety Code Section 1596.866.
This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on record review, both the licensee and her assistant did not comply with the section cited above as their current CPR/First Aid training certifications are from non-EMSA certified training provider IMaster CPR/First Aid which poses/posed a potential health, safety or personal rights risk to children in care.
POC Due Date:
11/07/2022
Plan of Correction
1
2
3
4
Licensee was provided with a listing of EMSA approved CPR/First Aid training providers by analyst and stated that she would complete a new training through one them and submit copies of the certifications by 11/07/22 to complete the correction.
Type B
Section Cited
CCR
102417(g)(7)
Operation of A Family Child Care Home
(7) An emergency information card shall be maintained for each child and shall include the child's full name, telephone number and location of a parent or other responsible adult to be contacted in an emergency, the name and telephone number of the child's physician and the parent's authorization for the licensee or registrant to consent to emergency medical care.
This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on record review, the licensee did not comply with the section cited above as she had no record files for any of the children in care at the home today which poses/posed a potential health, safety or personal rights risk to children in care.
POC Due Date:
10/06/2022
Plan of Correction
1
2
3
4
Licensee stated that all her children's records are kept on file digitally on her laptop which she did not have with her today. Licensee stated she will e-mail analyst a copy of the her files by 10/06/22 to show the records she has for her day care children to complete the correction.
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:
Jason Garay
LICENSING EVALUATOR NAME:
Luigi Gargaro
LICENSING EVALUATOR SIGNATURE:
DATE:
10/03/2022
I acknowledge receipt of this form and understand my
appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
10/03/2022
LIC809
(FAS) - (06/04)
Page:
7
of
11
Document Has Been Signed on
10/03/2022 03:31 PM
- It Cannot Be Edited
Created By:
Luigi Gargaro
On
10/03/2022
at
12:48 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:
SAID, FADUMA FAMILY CHILD CARE
FACILITY NUMBER:
376625397
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE:
10/03/2022
DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102417(g)(8)
Operation of A Family Child Care Home
(8) Each family child care home shall have a current roster of children as specified in Health and Safety Code Section 1596.841.
This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on record review, the licensee did not comply with the section cited above as the digitial copy of the roster she showed analyst on her phone today was missing several pieces of information which poses/posed a potential health, safety or personal rights risk to children in care.
POC Due Date:
10/06/2022
Plan of Correction
1
2
3
4
Licensee states she will update the facility roster and send analyst a copy of the new completed roster by 10/06/22 to complete the correction.
Type B
Section Cited
CCR
102425(c)
Infant Safe Sleep
An Individual Infant Sleeping Plan [LIC 9227 (3/20)] shall be completed for each infant up to 12 months of age the provider has in care and included in the infant's file at the facility.
This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on record review, the licensee did not comply with the section cited above as she does not have any LIC 9227 forms for the infants under 12 months old that she has in care which poses/posed a potential health, safety or personal rights risk to children in care.
POC Due Date:
10/06/2022
Plan of Correction
1
2
3
4
Analyst provided the licensee with a copy of an LIC 9227 form and she stated that she will have the respective parents complete then and send analyst a copy of the completed forms by 10/06/22 to complete the correction.
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:
Jason Garay
LICENSING EVALUATOR NAME:
Luigi Gargaro
LICENSING EVALUATOR SIGNATURE:
DATE:
10/03/2022
I acknowledge receipt of this form and understand my
appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
10/03/2022
LIC809
(FAS) - (06/04)
Page:
2
of
11
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:
SAID, FADUMA FAMILY CHILD CARE
FACILITY NUMBER:
376625397
VISIT DATE:
10/03/2022
NARRATIVE
1
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3
4
5
6
7
8
9
10
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13
14
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LPA provided and discussed the following: Report suspected child abuse and neglect, maintain children’s records according to regulation, post all required forms, and ensure that all adults residing or working in the home have criminal background clearances or exemptions. Licensee was reminded that corporal punishment, smoking, exersaucers, bouncy seats, walkers, and jumpers and/or similar equipment are not allowed in daycare. Licensee was also provided handouts with information regarding upcoming Safe Sleep Regulations/SIDS, Lead exposure and Shaken Baby Syndrome. LPA and Licensee discussed California Megan's Law and LPA provided:
www.meganslaw.ca.gov
.
LPA discussed and provided Licensee with the following: child care advocates email address:
[email protected]
. In addition, for general questions or questions regarding licensing requirements contact the Child Care Licensing Duty Line at (619) 767-2248.
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
.
California Code of Regulations, (Title 22, Division 12 & Chapter 3), one type A and eleven type B citations are being cited on the attached LIC 809-D.
Upon Receipt, licensee shall post and provide copies of this licensing report to parents/guardians of children in care at the facility and to parents/guardians of children newly enrolled at the facility during the next 12 months.
An exit interview was conducted with the licensee. The licensee was provided a copy of their appeal rights (LIC
9058
12/15) and their signature on this form acknowledges receipt of these rights.
LPA provided notice of site visit and observed it being posted at the facility.
SUPERVISORS NAME
:
Jason Garay
LICENSING EVALUATOR NAME
:
Luigi Gargaro
LICENSING EVALUATOR SIGNATURE
:
DATE:
10/03/2022
I acknowledge receipt of this form and understand my licensing appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
10/03/2022
LIC809
(FAS) - (06/04)
Page:
6
of
11