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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013422998
Report Date: 02/27/2023
Date Signed: 02/27/2023 11:00:33 AM

Document Has Been Signed on 02/27/2023 11:00 AM - 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:ABDO, PHALESTINAH & QAYUM, HALIMFACILITY NUMBER:
013422998
ADMINISTRATOR:ABDO, PHALESTINAHFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(408) 515-0500
CITY:FREMONTSTATE: CAZIP CODE:
94536
CAPACITY: 14TOTAL ENROLLED CHILDREN: 11CENSUS: 7DATE:
02/27/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:35 AM
MET WITH:Palastinah AbdoTIME COMPLETED:
11:10 AM
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On February 27, 2023 at approximately 8:30am Licensing Program Analyst (LPA) Haderer arrived unannounced for an annual inspection for health and safety. Present for today’s inspection was the Phalestinah Abdo and 7 children in care (ages 3 to 5 years old). The facility is in ratio today. Hours of operation remain Monday -Thursday 9:00am 2:00pm.

The facility is a single-story home with 3 bedrooms, 2 bathrooms, a large living room (two joined rooms), kitchen, family room, and an attached 2-car garage, front, back and side yards. There is an un-used fireplace in the off-limits family room that is blocked by bookcase and an air conditioner unit. The home has heating and ventilation for safety and comfort. Per the licensee, the ISOLATION AREA will be in the on-limits living room in a corner away from the other children in care.

ON LIMIT AREAS: Large double-room living room; house bathroom, short hallway to the bathroom; entire backyard. Licensee was reminded that other than wipes or things used for the children in the on limits children’s bathroom, they need to be empty of most all items (or locked up) such as cleaning products.



OFF LIMIT AREAS: All 3 bedrooms in the home, family room, kitchen and attached 2-car garage. The off-limit areas will be inaccessible by child gates, closed and/or locked doors and adult supervision.

The home has a fully charged 2A10BC fire extinguisher mounted on the wall of the living room, smoke detectors and carbon monoxide detector (all tested and working) and a working telephone. Fire drills are conducted at least once each 6 months, the last drill was completed on 11-16-2022. Licensee has ample age-appropriate toys and learning materials inside and outside the home. Per licensee, there are no firearms in the home. Drop-down cribs are not used nor allowed at the day-care facility. Toxins, medicines, and hazardous items were inaccessible during today's inspection.
SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Russell Haderer
LICENSING EVALUATOR SIGNATURE: DATE: 02/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/27/2023
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, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: ABDO, PHALESTINAH & QAYUM, HALIM
FACILITY NUMBER: 013422998
VISIT DATE: 02/27/2023
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There is a large wooden play structure in the backyard with a slide, swings and monkey bars. The structure is free from hazards. Licensee has a trampoline for children’s use, licensee follows the manufacture’s safety requirements and only one child is allowed to use it at one time; adult supervision is always present. There is also a balance beam that can only be used by one child at a time and is allowed as long as there are rubber mats on both sides of the beam and adult supervision is present at all times.

Children’s files were reviewed and found to be complete and well organized. The facility roster was reviewed, and a copy obtained. All files were organized and complete. The licensee rents the property, and carries liability insurance through Progressive.

LPA reviewed facility files. Personnel files were available for the licensee and assistants. Proof of all immunization records required by Title 22 for a family childcare home were available and reviewed for all staff. CPR / 1st Aid was available for licensee, expires 11-20-2023, assistants expire on 1-2-2024 and 2-17-2025. Mandated Reporter was completed and current for licensee, done 3/15/2022, assistants were done 3-17-2022 and 12-06-2022. Licensee was reminded that Mandated Reported and CPR/1st Aide is to be renewed every two years.

Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

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

SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Russell Haderer
LICENSING EVALUATOR SIGNATURE:

DATE: 02/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/27/2023
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, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: ABDO, PHALESTINAH & QAYUM, HALIM
FACILITY NUMBER: 013422998
VISIT DATE: 02/27/2023
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To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.


There were no deficiencies issued today. This report will remain on file for three years.

A notice of site visit was given and must remain posted for 30 days.



Exit interview conducted and report was reviewed with the licensee Phalestinah Abdo.
SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Russell Haderer
LICENSING EVALUATOR SIGNATURE:

DATE: 02/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/27/2023
LIC809 (FAS) - (06/04)
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