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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 334846112
Report Date: 01/23/2025
Date Signed: 01/23/2025 10:47:40 AM

Document Has Been Signed on 01/23/2025 10:47 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
RIVERSIDE CC RO, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME:SALLY FAMILY CHILD CAREFACILITY NUMBER:
334846112
ADMINISTRATOR/
DIRECTOR:		SALLY,TUANFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(714) 823-1444
CITY:CORONASTATE: CAZIP CODE:
92879
CAPACITY: 14TOTAL ENROLLED CHILDREN: 3CENSUS: 2DATE:
01/23/2025
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:20 AM
MET WITH:Licensee's Tuan and Fathima SallyTIME VISIT/
INSPECTION COMPLETED:
11:00 AM
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On 01/23/2025 at 8:20 AM Licensing Program Analyst (LPA) Susan Brewer arrived at the facility to conduct an annual inspection. LPA was greeted by Licensees Twan Sally and Fathima Sally. The licensees granted the LPA entry to tour the facility inside and out. LPA reviewed records and observed and/or discussed the following: No other adults were present during the inspection. The licensees agree to submit the LIC999A Facility Sketch for the 2nd Floor. The hours of operation were updated.

Normal days and hours of operation: Monday-Friday, 6:00 AM to 6:00 PM
OFF-LIMIT AREAS INCLUDE: Garage, Entire 2nd Floor, the 2 side yards.

The inspection consisted of reviews of the following domain: Physical Plant, Care and Supervision, Records, Facility Administration, Staffing Ratio and Capacity, Personal Rights. The inspection found the facility to be in compliance in these domains, except as noted on the LIC809D.
· The facility is operating within the licensed capacity and appropriate ratios. LPA took a census of 2 children in care.
· The Licensee is present in the home and has ensured that children in care are supervised.
· When temporarily absent from the home, the Licensee shall arrange for a substitute adult to care for and supervise children.
· A working telephone is present.
· A fully charged fire extinguisher (2A:10BC) was observed and tagged by the fire department and needle in the green. A smoke detector and carbon monoxide detector were present and tested by the licensee during this inspection.
· All hazardous items are inaccessible, this includes detergents, cleaning compounds, medications and other items which could pose a danger to children.
· Storage of poisons are inaccessible to children and are locked.
· Stairs are barricaded at this time.
SUPERVISORS NAME: Ana Noble
LICENSING EVALUATOR NAME: Susan Brewer
LICENSING EVALUATOR SIGNATURE: DATE: 01/23/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/23/2025
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
RIVERSIDE CC RO, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME: SALLY FAMILY CHILD CARE
FACILITY NUMBER: 334846112
VISIT DATE: 01/23/2025
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· The fireplace is properly screened.
· No guns or weapons present as stated by the Licensees Tuan and Fathima Sally. The licensees understand all guns, weapons and ammunition must be key locked separately and made inaccessible per Title 22 regulations.
· Home is clean and orderly, with heating and ventilation for safety and comfort.
· Clean, Safe and age-appropriate toys and equipment are present for both indoor and outdoor activities.
· Outdoor play areas are fenced and/ or appropriate supervision is present.
· Verification of control of property on file by tax statement.
· Pediatric CPR and First Aid training on 07/2023; Card expires on 07/2025 for both licensees
· Health & Safety Certificate – completed for both licensee on 07/08/2021
· Mandated reporter General: 08/28/2021 and AB 1207 Child Care Expires: 10/22/2025 for both licensees
· Fire clearance: 09/21/2023
· Documentation of fire & earthquake drills to be conducted every six months: Last drill on 09/20/2024.
· There are no bodies of water, 01/23/2025. The licensees Tuan and Fathima Sally, understand all bodies of water including ponds, above ground pools & spas, in-ground pools & spas, and some fountains must be properly covered or fenced per Title 22 regulations. The Department must be notified before and after installation of the above types of bodies of water. In addition, all wading pools or similar product must be emptied immediately after use and stored in an upright position.
· Children’s files are complete on today’s date.
· Staff’s files are complete: N/A, the licensees are operating on their own and no employees at this time.
· A review of staff records on 01/23/2025 indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.

To receive important licensed-related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.
SUPERVISORS NAME: Ana Noble
LICENSING EVALUATOR NAME: Susan Brewer
LICENSING EVALUATOR SIGNATURE:

DATE: 01/23/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/23/2025
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
RIVERSIDE CC RO, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME: SALLY FAMILY CHILD CARE
FACILITY NUMBER: 334846112
VISIT DATE: 01/23/2025
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For IMS information, see PIN 22-02-CCP. 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

The licensees Tuan and Fathima Sally, were 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.

LPA Susan Brewer, discussed the safe sleep regulations with licensees Tuan and Fathima Sally, 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 as an additional resource.

LPA also informed licensees Tuan and Fathima Sally, of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

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/process.

No deficiencies were issued on today’s date.
No civil penalties issued on today’s date.
A notice of site visit was given and must remain posted for 30 days.
Exit interview conducted and report was reviewed with the licensees Tuan and Fathima Sally.
SUPERVISORS NAME: Ana Noble
LICENSING EVALUATOR NAME: Susan Brewer
LICENSING EVALUATOR SIGNATURE:

DATE: 01/23/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/23/2025
LIC809 (FAS) - (06/04)
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