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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013419047
Report Date: 04/25/2022
Date Signed: 04/25/2022 12:58:31 PM

Document Has Been Signed on 04/25/2022 12:58 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:ADAM, NOREEN DANISHFACILITY NUMBER:
013419047
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 0DATE:
04/25/2022
TYPE OF VISIT:Case Management - OtherANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Noreen Danish Adam- LicenseeTIME COMPLETED:
01:05 PM
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On 4/25/22 at 10:30am, Licensing Program Analyst Briana Plumboy met with licensee Noreen Danish for an ANNOUNCED CASE MANAGEMENT INSPECTION. Present for this visit was licensees 3 teenage children, and two fire inspectors from the Union City Fire Department. The home was toured by LPA Plumboy, licensee, and the two fire inspectors.

The purpose of the site visit was to discuss safety concerns found on 4/20/22 for the continued use of the home as a family childcare. The concerns were found to be within an unpermitted room which is attached to the rear of the home and inside the garage. The licensee is aware prior to reactivating her license a licensed electrician must pull the electrical plans from the Union City Building Department prior to performing electrical wiring in the home and provide signed documentation in regards to the electrical wiring in the home being safe. Licensee is also aware unpermitted spaces which are not approved by the City of Union City's Building Department may not be used as on limit areas for childcare. Effective 4/25/22, the family childcare home is being placed on inactive status until 6/24/22. LPA Plumboy received a signed Lic. 9211 from licensee.

As a result of this visit, there are no deficiencies cited. This report shall remain on file for 3 years. Exit interview conducted.
SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Briana Plumboy
LICENSING EVALUATOR SIGNATURE: DATE: 04/25/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/25/2022
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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