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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376629420
Report Date: 04/22/2024
Date Signed: 04/22/2024 12:26:28 PM

Document Has Been Signed on 04/22/2024 12:26 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:BAHATI, LADIYA FAMILY CHILD CAREFACILITY NUMBER:
376629420
ADMINISTRATOR/
DIRECTOR:		LADIYA BAHATIFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(619) 597-0578
CITY:SAN DIEGOSTATE: CAZIP CODE:
92105
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 5DATE:
04/22/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:17 AM
MET WITH:Ladiya BahatiTIME VISIT/
INSPECTION COMPLETED:
11:20 AM
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On April 22, 2024, at 10:17 AM Licensing Program Analyst (LPA) Jo Ann Legaspi conducted a case management inspection to follow-up on an incident that occurred on 04/18/2024. LPA advised Licensee Ladiya Bahati of the meeting’s purpose and was granted facility entry. Licensee provided LPA with a facility tour. There were five (5) children with the licensee.

A child sustained an injury and required medical treatment on 04/18/2024. The incident was self reported by the licensee. There were three (3) children with the licensee during the incident. On 04/18/2024, at around 5:45 PM, a child jumped and injured their chin. Licensee immediately attended to the child by cleaning and dressing their wound. The parent and licensee do not speak the same language; thus, the licensee contacted an outside source to notify the parent. The parent took their child to the hospital where they received stitches on their chin.

During today’s visit, LPA inspected the living room area where the incident occurred. There were no apparent hazards accessible to children. LPA observed play equipment and furniture to be age-appropriate No deficiencies cited.

A notice of site visit was given to licensee and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days. Licensee/Appeal Rights (LIC 9058) was provided to the licensee. Exit interview conducted and report was reviewed with the Licensee Ladiya Bahati.

SUPERVISORS NAME: Tulam Vu
LICENSING EVALUATOR NAME: JoAnn R Legaspi
LICENSING EVALUATOR SIGNATURE: DATE: 04/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/22/2024
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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