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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 136610628
Report Date: 06/30/2023
Date Signed: 07/01/2023 07:17:18 AM

Document Has Been Signed on 07/01/2023 07:17 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, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME:HALEEM, ROSA FAMILY CHILD CAREFACILITY NUMBER:
136610628
ADMINISTRATOR:ROSA HALEEMFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(760) 481-4963
CITY:EL CENTROSTATE: CAZIP CODE:
92243
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 0DATE:
06/30/2023
TYPE OF VISIT:Case Management - Licensee InitiatedANNOUNCEDTIME BEGAN:
10:05 AM
MET WITH:Rosa HaleemTIME COMPLETED:
10:40 AM
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On 6/30/23 at 10:05 a.m., Licensing Program Analyst (LPA) Cindy Meier conducted a follow up announced Change of Location, Change of Capacity inspection with applicant, Rosa Haleem. The purpose of the inspection is to ensure the home is in compliance with standards established in CCR, Title 22, Division 12, Chapter 3, for Family Child Care Homes. This one story, five bedroom, three bath house was toured and inspected. The hours of operation are Monday through Saturday, 6:00 a.m. to 6:00 p.m.

The following corrections have been completed for the issuance of the license:
· Applicant’s spouse obtains documentation of MMR and DTp immunization's.
· Applicant’s husband completes EMSA approved CPR and First Aid.
· Pool fence and gate are repaired to meet regulations.

A Regular Large Family Child Care Home license may be issued upon final file review. LPA Meier explained inspection report to applicant, applicant stated.
SUPERVISORS NAME: Jason Garay
LICENSING EVALUATOR NAME: Cindy Meier
LICENSING EVALUATOR SIGNATURE: DATE: 06/30/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/30/2023
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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