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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 015700288
Report Date: 12/19/2022
Date Signed: 12/19/2022 02:53:39 PM

Document Has Been Signed on 12/19/2022 02:53 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:BAWAZIR, ABDULLAHFACILITY NUMBER:
015700288
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 1DATE:
12/19/2022
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
01:15 PM
MET WITH:Abdullah BawazirTIME COMPLETED:
02:41 PM
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On Dec 19, 2022 Licensing Program Analyst (LPA) Cortez conducted a case management visit for a capacity increase inspection. Present in the home today was the licensee Abdullah Bawazir, and one pre-school age child. All requested documents were received for the increase of capacity application. The fire clearance for a capacity of 14 was received from the Hayward Fire Department . Ratios were discussed including proper ratio compliance in case an assistant is unavailable for a day and or does not come due to illness etc. The Licensee was reminded that whenever an assistant is not present, the licensee will comply with the capacity requirements

The home is neat and clean with adequate ventilation for safety and comfort. On limit area: are the living room, dining room, family room, kitchen and the 2 bedrooms, and 1 bathroom. The off limit areas will the master bedroom and master bathroom, and the garage. The isolation area will be: 3rd room at the end of the hall. There is a fully fenced outdoor yard and play area. The outdoor fenced side of the house is off limits to children in care. There are ample age appropriate toys and furnishings that are safe and in good repair. There are no pools, hot tubs or any other accessible bodies of water. All hazardous materials and toxins are kept out of the reach of children and it was observed that there are no toxins or hazardous items accessible during today's inspection. The home has a fully charged 3A40BC fire extinguisher, working smoke detector, working carbon monoxide detector, working telephone.

There are no deficiencies cited on this visit.



The home is recommended for a Large Family Child Care Home License effective today, 12/19/2022. Exit interview conducted and report was reviewed with the Licensee,
SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Sidney Cortez
LICENSING EVALUATOR SIGNATURE: DATE: 12/19/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/19/2022
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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