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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376100671
Report Date: 10/24/2022
Date Signed: 10/24/2022 10:22:28 AM

Document Has Been Signed on 10/24/2022 10:22 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:ALKHAWRI, SUHA FAMILY CHILD CAREFACILITY NUMBER:
376100671
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 2DATE:
10/24/2022
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Suha AlkhawriTIME COMPLETED:
10:40 AM
NARRATIVE
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On 10/24/22 at 9:00 AM LPA Annette Sutherland conducted an unannounced case management site visit for a capacity increase. This visit is to verify that the licensee remains in substantial compliance with the health & safety standards as required by regulations governing family childcare homes. LPA met with licensee Suha Alkhawri. Also present was Licensee’s husband Firas Alkhawri and 2 minor children. Licensee has all appropriate forms posted. LPA confirmed with licensee that all adults residing/working in the home have criminal record/TB clearances. Applicant owns the home. The home appears to be large enough to comfortably accommodate 14 children. Fire clearance was received on 10/18/22. First Aid and CPR certifications has expired. Licensee has made appointment for November 16th, 2022. Children’s records were reviewed and found to be in order. Licensee has practiced fire/emergency drills with daycare children according to regulations. Fire drills have not been recorded.
The one story home (3 bedrooms, 2 bathrooms) was toured, the following areas are used for daycare: Living room, Dining room, Kitchen, Bedroom #1, Bathroom #1 and Front yard.
Off limit areas include: Bedroom #2 and #3, Bathroom #2, Garage, and Backyard.
Drawers and lower cabinets in kitchen are either latched or do not contain any hazardous items. There is an operational smoke alarm, carbon monoxide detector and fire extinguisher maintained in the home. There are adequate age appropriate toys. There are no firearms present on the premises as stated by licensee. There is a fenced pool in the backyard that meets title 22 regulations, applicant is aware that supervision is required at all times when in the pool area. Applicant stated the Backyard and pool will be off limits and will not be used while children are in care. Outdoor play area is a fenced front yard, which is free of hazards . Per licensee, operating hours are from 7:00 AM- 12:00 PM; Monday – Saturday.
SUPERVISORS NAME: Monica Cuddy
LICENSING EVALUATOR NAME: Annette Sutherland
LICENSING EVALUATOR SIGNATURE: DATE: 10/24/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/24/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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Document Has Been Signed on 10/24/2022 10:22 AM - It Cannot Be Edited


Created By: Annette Sutherland On 10/24/2022 at 09:44 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: ALKHAWRI, SUHA FAMILY CHILD CARE
FACILITY NUMBER: 376100671

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/24/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
11/24/2022
Section Cited
HSC
1596.866(c)(2)

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1596.866(c)(2) From the Health & Safety Code - The licensee’s Pediatric CPR and First Aid cards are not current. They expired on 8/2022.
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Licensee will enroll and complete an approved First Aid and CPR class. Licensee has enrolled in class. Class is scheduled for November 16th. Licensee will provide proof to LPA by email Annette.sutherland@dss.ca.gov by 11/24/22.
Type B
10/31/2022
Section Cited
CCR
102417(g)(9)(A)

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Family Child Care regulation 102417(g)(9)(A)
Requires each family child care home to conduct fire drills and disaster drills at least once every 6 months.
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Document the drills, including the date and time of each drill. Licensee will provide proof to LPA by email Annette.sutherland@dss.ca.gov by 10/31/22.

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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:Annette Sutherland
LICENSING EVALUATOR SIGNATURE:
DATE: 10/24/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/24/2022


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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: ALKHAWRI, SUHA FAMILY CHILD CARE
FACILITY NUMBER: 376100671
VISIT DATE: 10/24/2022
NARRATIVE
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LPA reviewed the following: required departmental documents, regulation highlights, community resources, capacity limitations, supervision, clearances, emergency drills, heat-related illness, child passenger law, unusual incidents, mandated reporting, Assembly Bill 633, SIDS, Safe sleep regulations, Shaken Baby Syndrome, Megan's law and Covid information. Applicant is reminded that corporal punishment, smoking, walkers, exersaucers, jumpers and bouncy seats shall never be permitted during daycare operation. Any equipment used should only be used according to the manufacturer recommendations. For licensing regulations/updates/forms, go to webpage http://www.ccld.ca.gov
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.

The following item (s) need(s) to be corrected prior to the issuance of the large license. Licensee understands that if corrections are not made within 30 days, the application to increase the capacity may be denied.

1) CPR must be taken
2) Fire Drills need to be conducted and recorded
Once corrections are made and proof is sent to licensing a license for 14 children will be granted. Applicant understands that proof of corrections must be submitted to Licensing within 30 days or the application may be denied. Applicant agreed to comply withal regulations and laws governing family child care homes.

An exit interview was conducted with applicant.
The licensee was provided a copy of their appeal rights (LIC 9058 12/15) and their signature on this form acknowledges receipt of these rights. LPA provided notice of site visit and observed it being posted at the facility.
SUPERVISORS NAME: Monica Cuddy
LICENSING EVALUATOR NAME: Annette Sutherland
LICENSING EVALUATOR SIGNATURE:

DATE: 10/24/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/24/2022
LIC809 (FAS) - (06/04)
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