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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304313773
Report Date: 10/14/2024
Date Signed: 10/18/2024 09:51:42 AM

Document Has Been Signed on 10/18/2024 09:51 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
ORANGE CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME:ABU-JIBNEH, NARMINFACILITY NUMBER:
304313773
ADMINISTRATOR/
DIRECTOR:		ABU-JIBNEH, NARMINFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(714) 232-3559
CITY:IRVINESTATE: CAZIP CODE:
92604
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 0DATE:
10/14/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:15 AM
MET WITH:LicenseeTIME VISIT/
INSPECTION COMPLETED:
11:30 AM
NARRATIVE
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An Annual Random inspection was conducted at the facility by Licensing Program Analyst (LPA) Mahnaz (Nancy) Malek. LPA met with adult, Samer Suleiman and then with licensee, Narmin Abu-Jibneh. The licensee informed LPA that today she did not have any children due to a public school holiday. LPA was let in. LPA and the licensee toured the home. The facility is licensed for Large Family Childcare Home.

A review of the Facility Personnel Report Summary on this date indicates all facility residents, staff, or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.

According to the updated information received, currently there are three adults including the licensee, and no minors living in the house. Day care hours of operation is Monday through Friday from 8:00 am-6:00 pm.

During today’s inspection, LPA and the licensee toured the inside and outside areas identified in the facility sketch as accessible to childcare children. Off limits areas are made inaccessible by means of baby gates. The childcare area consists of family room, children's bathroom and backyard. Parents enter from the front door. The childcare area has a gate in front of it that separates the room from the other parts of the home. Children's bathroom is located in the hallway. Licensee stated she escorted the children to the bathroom since it is located in the off-limits area. The backyard was inspected. The fire pit is locked through the gas pipe line and inaccessible to children. There is a low high play structure with slide located on the grass area. There are age appropriate toys and equipment for children to play outside.

There is no body of water observed. There is no weapon and there is no pet living in the home.

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SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Mahnaz Malek
LICENSING EVALUATOR SIGNATURE: DATE: 10/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/14/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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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
ORANGE CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME: ABU-JIBNEH, NARMIN
FACILITY NUMBER: 304313773
VISIT DATE: 10/14/2024
NARRATIVE
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LPA observed 3 cribs available for infants. Older children nap on cots.
The garage is not for children's use and is inaccessible to children by the garage door being locked. Garage entrance is from the kitchen in the off-limit area.

There are working carbon monoxide, smoke detector, and fire extinguishers in the home that meet statutory and State Fire Marshall standards.

Detergents, cleaning compounds, medicines, and other items which could pose a danger to children were not readily available to children they were stored inaccessible to children, none were observed during inspection.

LPA verified there is a working telephone service (cellular service).

The licensee does have a current roster of children in care. Fire Drill was available. The last fire drill was conducted 6/8/2024. Children’s records for children enrolled were reviewed. Twelve files were reviewed. There were no log for every 15 minutes check on napping children under 24 months old. LIC 9227 (Individual Infant Sleeping Plan) for infants under 12 months old was given to licensee. The assistant's file was also reviewed.

Beginning September 1, 2016, Health and Safety (H&S) 1597.622 states, a person shall not be employed or volunteer at a family childcare home if he or she has not been immunized against influenza, pertussis, and measles. Proof of immunization against measles for adult # 2 was missing.

Beginning March 31, 2018, H&S Code 1596.8662 requires all licensed providers and employees to complete mandated reporting training, and to renew the training every two years. The licensee is exempt of this requirement because this course is not offered in other languages other than English and Spanish. The licensee is exempt because the training course e is not offered in licensee's native language.
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SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Mahnaz Malek
LICENSING EVALUATOR SIGNATURE:

DATE: 10/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/14/2024
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
ORANGE CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME: ABU-JIBNEH, NARMIN
FACILITY NUMBER: 304313773
VISIT DATE: 10/14/2024
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Incidental Medical Services (IMS) policy was discussed. For information see PIN 22-02-CCP. 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: https://www.ada.gov/resources/child-care-centers/.

The licensee understands they must be present in the facility and must ensure children in care are always supervised. Children are not to be left alone in parked vehicles. When the licensee is temporarily absent from the facility, arrangements must be made for a qualified substitute adult to care and supervise children while absent. The substitute adult must have the required criminal record, child abuse index clearances, immunization, Pediatric CPR/First Aid, and mandated reporter training.

Licensee, Narmin Abu-Jibneh was reminded that all adults 18 and over living in the home, persons who provide care and supervision to children, and staff who have contact with children, including employees and clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance before working in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day for a maximum of 5-days or, if the penalty is for a repeat violation, for a maximum of 30-days per person will be assessed if this regulation is violated.

LPA discussed the safe sleep regulations with License Narmin Abu-Jibneh and discussed the Child Care Licensing Safe Sleep webpage at:

https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep,

LPA also informed Licensee, Narmin Abu-Jibneh of the importance of checking for recalled as infant devices on the United States Consumer Product Safety Commission (CPSC) website at: https://www.cpsc.gov/, and

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SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Mahnaz Malek
LICENSING EVALUATOR SIGNATURE:

DATE: 10/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/14/2024
LIC809 (FAS) - (06/04)
Page: 3 of 6
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME: ABU-JIBNEH, NARMIN
FACILITY NUMBER: 304313773
VISIT DATE: 10/14/2024
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recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

Licensee, Narmin Abu-Jibneh was informed of the MyChildCarePlan.org site, a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California. Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platforms.

To receive important licensed related information to licensed facilities, visit the CCLD Important Information website athttps://www.cdss.ca.gov/inforesources/community-care- licensing/subscribe and select the Child Care option to receive email communication.

In the areas that were evaluated, the following deficiencies were observed of the California Code of Regulations, Title 22, Division 12 on this inspection. Please see LIC809D for details of deficiencies.

A notice of site visit was given to Licensee's representative, Sophia Isales and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days. Failure to post will result in Civil Penalties of $100.00.

Exit interview conducted and report was reviewed with the Licensee, Narmin Abu-Jibneh

End of report

SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Mahnaz Malek
LICENSING EVALUATOR SIGNATURE:

DATE: 10/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/14/2024
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 10/18/2024 09:51 AM - It Cannot Be Edited


Created By: Mahnaz Malek On 10/14/2024 at 10:09 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: ABU-JIBNEH, NARMIN
FACILITY NUMBER: 304313773

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/14/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102416(c)
Personnel Requirements
(c) The licensee and other personnel as specified shall complete training on preventive health practices, including pediatric cardiopulmonary resuscitation and pediatric first aid, pursuant to Health and Safety Code Section 1596.866.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation and record review, the licensee did not comply with the section cited above in one count out of one file missing CPR and 1st aid for adult # 1 which poses a potential health, and safety's risk to persons in care.
POC Due Date: 10/30/2024
Plan of Correction
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The licensee agreed to obtain CPR and 1st aide training completed and send it to LPA's email address by the due date of 10/30/2024.
Type B
Section Cited
HSC
1597.622(a)(1)
General Provisions and Definitions
(1) Commencing September 1, 2016, a person shall not be employed or volunteer at a family day care home if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation and record review, the licensee did not comply with the section cited above in one count out of two files, missing MMR and Flu shot for adult # 2 which poses a potential health, and safety's risk to persons in care. Flu shot may be declined by a written statement.
POC Due Date: 10/30/2024
Plan of Correction
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The licensee agreed to obtain MMR vaccine for Adult # 2 and send it to LPA's email address by the due date of 10/30/2024.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Thuy Ho
LICENSING EVALUATOR NAME:Mahnaz Malek
LICENSING EVALUATOR SIGNATURE:
DATE: 10/14/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/14/2024


LIC809 (FAS) - (06/04)
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Document Has Been Signed on 10/18/2024 09:51 AM - It Cannot Be Edited


Created By: Mahnaz Malek On 10/14/2024 at 10:09 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: ABU-JIBNEH, NARMIN
FACILITY NUMBER: 304313773

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/14/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102418(a)
Immunizations
(a) Prior to admission to a family day care home, children shall be immunized against diseases as required by the California Code of Regulations, Title 17, beginning with Section 6000.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation and record review, the licensee did not comply with the section cited above in four counts out of twelve files, missing immunization for Child # 3, 4, 9, and 11 which poses a potential health, and safety's risk to persons in care.
POC Due Date: 10/30/2024
Plan of Correction
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The licensee agreed to obtain immunization for the above children and send it to LPA's email address by the due date of 10/30/2024.
Type B
Section Cited
CCR
102425(c)(2)
Infant Safe Sleep
An Individual Infant Sleeping Plan [LIC 9227 (3/20)] shall be completed for each infant up to 12 months of age the provider has in care and included in the infant's file at the facility. The Individual Infant Sleeping Plan [LIC 9227 (3/20)] shall be maintained in the infant’s file and shall be available to the Department for review.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation and record review, the licensee did not comply with the section cited above in four counts out of four files, missing log for every 15 minutes check on children under 24 months old for Child # 2, 9, 10, and 12 which poses a potential health, and safety's risk to persons in care.
POC Due Date: 10/30/2024
Plan of Correction
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The licensee agreed to complete the log for every 15 minutes check on the above children and send it to LPA's email address by the due date of 10/30/2024.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Thuy Ho
LICENSING EVALUATOR NAME:Mahnaz Malek
LICENSING EVALUATOR SIGNATURE:
DATE: 10/14/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/14/2024


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