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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376100060
Report Date: 02/02/2022
Date Signed: 02/02/2022 11:49:35 AM

Document Has Been Signed on 02/02/2022 11:49 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:ALAWAD, SHAHA FAMILY CHILD CAREFACILITY NUMBER:
376100060
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 2DATE:
02/02/2022
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
09:25 AM
MET WITH:Shaha AlawadTIME COMPLETED:
11:59 AM
NARRATIVE
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On 2/2/22 at 9:25 AM, Licensing Program Analyst (LPA) Keturah Lane conducted an unannounced inspection for a capacity increase with the applicant. Upon arrival, LPA met with Licensee, Shaha Alawad. Also present in the home were Faisal Alawad, Bilal Alawad, Anwar Alawad and three minors that live in the home. Licensee speaks Arabic and one of the minors in the home helped with translation. The two-story house was toured and inspected to ensure an environment safe for the care and supervision of children. The entire second story is off-limits. The fire extinguisher and carbon monoxide detector meet requirements and are operational. The smoke detector was not operational. Licensee stated she needs to get a new battery for it. All hazardous items were latched/locked and secured out of reach of children. Outlets were covered and cords were not accessible. Fireplace is screened. LPA observed infant crib in dining room with a blanket and pillow in it. Licensee removed the blanket and pillow and LPA reminded her that it can only have a tight-fitting sheet on it and no other items in the crib. There are no bodies of water on the property. Licensee states that there are no weapons in the home. Licensee was 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 minimum/day up to $500 maximum per day/per person will be assessed if this regulation is violated. Applicant has obtained landlord consent to care for 14 children. The home appears to be large enough to comfortably accommodate 14 children. Fire clearance was received on 12/9/21. First Aid and CPR certifications expire September 2023. Licensee meets immunizations requirements. Mandated Reporter Training was waived due to language barrier. Licensee has an updated roster. LPA reviewed children’s records and found them to be complete. Licensee did not have a safe sleep log for one child aged 17 months. Licensee stated she does not have any children in care under 1 year of age. (continued on LIC809-C...)
SUPERVISORS NAME: Monica Cuddy
LICENSING EVALUATOR NAME: Keturah Lane
LICENSING EVALUATOR SIGNATURE: DATE: 02/02/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/02/2022
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME: ALAWAD, SHAHA FAMILY CHILD CARE
FACILITY NUMBER: 376100060
VISIT DATE: 02/02/2022
NARRATIVE
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Applicant will be using the following rooms for childcare: living room, kitchen, saloon and bathroom. The following areas will be off limits: entire second floor which includes 4 bedrooms and 2 additional bathrooms and are inaccessible by use of safety gate at the bottom of the stairs. The back yard and garage are also off-limits and are inaccessible by use of door-knob covers and door locks. Applicant states she takes the children to a nearby park and understands visual supervision is required at all times during outdoor activities. The applicant has sufficient toys and equipment available.

The following information was reviewed with the applicant: information on reporting requirements for suspected child abuse and unusual incidents, children’s records, immunizations, adults living or working in the home and related civil penalties, shaken baby syndrome, Safe Sleep Regulation/SIDS. Applicant was reminded that corporal punishment, smoking, walkers, exersaucers, bouncy seats and jumpers are not allowed in day care. All equipment that is used should be used only as intended by the manufacturer. LPA and Licensee discussed California Megan's Law and LPA provided: www.meganslaw.ca.gov.

LPA discussed the safe sleep regulations with licensee 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 licensee of the importance for 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.

Deficiencies cited – see LIC809-D…

Once all proof of corrections are made and proof is sent to licensing a license for 14 children may be granted. Application will be under management review. Applicant understands that proof of corrections must be submitted to Licensing within 30 days or the application may be denied. Applicant agreed to comply with all regulations and laws governing family child-care homes. (continued on LIC809-C...)
SUPERVISORS NAME: Monica Cuddy
LICENSING EVALUATOR NAME: Keturah Lane
LICENSING EVALUATOR SIGNATURE:

DATE: 02/02/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/02/2022
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
CCLD Regional Office, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME: ALAWAD, SHAHA FAMILY CHILD CARE
FACILITY NUMBER: 376100060
VISIT DATE: 02/02/2022
NARRATIVE
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Incidental Medical services (IMS) policy was discussed. For IMS information see Evaluator Manual – Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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: http://www.ada.gov/childqanda.htm.

Exit interview conducted and report was reviewed with Licensee, Shaha Alawad. A Notice of Site Visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
SUPERVISORS NAME: Monica Cuddy
LICENSING EVALUATOR NAME: Keturah Lane
LICENSING EVALUATOR SIGNATURE:

DATE: 02/02/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/02/2022
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 02/02/2022 11:49 AM - It Cannot Be Edited


Created By: Keturah Lane On 02/02/2022 at 10:47 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
, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108

FACILITY NAME: ALAWAD, SHAHA FAMILY CHILD CARE
FACILITY NUMBER: 376100060

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/02/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/16/2022
Section Cited
CCR
102417(g)(1)

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102417 Operation of a Family Child Care Home (g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not be limited to: (1)... The home shall contain a fire extinguisher and smoke detector device which meet standards established by the State Fire Marshal. This requirement was not met as evidenced by...
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Licensee stated she would fix or replace the smoke detector and send a video testing it to LPA Lane via e-mail by 2/16/22.
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Based upon LPA observation and Licensee statement, the smoke detector was not operational which is a potential health, safety and personal rights risk to children in care.
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Type B
02/16/2022
Section Cited
HSC102425(j)(2)(D)

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102425 - Infant Safe Sleep (j)The provider shall supervise infants while they are sleeping and adhere to the following requirements: (2) The provider shall check and document the following: (D) Documentation shall be maintained in the infant’s file and be available to the Department for review. Documentation shall include the following:
a. Date.
b. Infant’s name.
c. Time of each 15-minute check. This requirement was not met as evidenced by:
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 Licensee stated she would send proof of the sleep log document for days child is in care 2/3/22 - 2/11/22 and submit to LPA Lane via e-mail by 2/16/22.
E-mail: Keturah.Lane@dss.ca.gov
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Based on observation & Licensee statement, the licensee did not comply with the section cited above. Licensee did not have a Safe Sleep Log, which poses a potential health, safety or personal rights risk to persons in care.
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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:Monica Cuddy
LICENSING EVALUATOR NAME:Keturah Lane
LICENSING EVALUATOR SIGNATURE:
DATE: 02/02/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/02/2022


LIC809 (FAS) - (06/04)
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