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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 015700288
Report Date: 10/23/2023
Date Signed: 10/23/2023 12:02:04 PM

Document Has Been Signed on 10/23/2023 12:02 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
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME:BAWAZIR, ABDULLAHFACILITY NUMBER:
015700288
ADMINISTRATOR:BAWAZIR, ABDULLAHFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(630) 220-2032
CITY:HAYWARDSTATE: CAZIP CODE:
94544
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 2DATE:
10/23/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:32 PM
MET WITH:Abdullah BawazirTIME COMPLETED:
03:02 PM
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Licensing Program Analyst Sidney Cortez, met with licensee for Abdullah Bawazir, for an UNANNOUNCED ANNUAL RANDOM INSPECTION. Present for this visit was the licensee Abdullah Bawazir and 2 pre-school age child. The home was toured to conduct a Health and Safety Inspection. The facility currently operates from 8:00AM until 3:00 PM, MONDAY-FRIDAY.


The home is 1 story. The home consists of 3 bedrooms, 2 bathrooms, living room, kitchen, backyard, garage. 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 the living room. 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. The home has a fully charged 3A40BC fire extinguisher, working smoke detector, working carbon monoxide detector, working telephone. The licensee’s Health and Safety training is completed and CPR and First Aid certificates are current and expire JAN 2025. The applicant is in compliance with new immunization laws which pertain to day care providers. Per licensee, there are no firearms in the home. The licensee's mandated reporter training is current and expires (Sept, 2025). The licensee conducts and documents fire and disaster drills twice a year with the last one conducted in OCT, 2023. 2 Children files were reviewed, facility roster reviewed and copy obtained. The licensee is in ratio today. All REQUIRED forms are posted and visible for public review.
SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Sidney Cortez
LICENSING EVALUATOR SIGNATURE: DATE: 10/23/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/23/2023
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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