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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376100692
Report Date: 09/06/2023
Date Signed: 09/06/2023 04:21:35 PM

Document Has Been Signed on 09/06/2023 04:21 PM - 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:ALTAIE, IKTIFA FAMILY CHILD CAREFACILITY NUMBER:
376100692
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 4CENSUS: 4DATE:
09/06/2023
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
02:35 PM
MET WITH:Licensee, Iktifa Altaie TIME COMPLETED:
03:45 PM
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Licensing Program Analyst (LPA) Jennifer Lott conducted a Plan of Correction visit regarding deficiencies that were cited on 07/26/2023. LPA was greeted at the front door by Licensee, Iktifa Altaie and was granted entry after identifying herself and disclosing the reason for the visit.

During today’s visit, LPA toured the facility to confirm corrections had been made.

Since the deficiencies have been corrected, they were cleared during the visit. Exit interview was conducted and report was reviewed with Licensee, Altaie. A notice of site visit was given and must remain posted for 30 days.
SUPERVISORS NAME: Tashima Daniel
LICENSING EVALUATOR NAME: Jennifer Lott
LICENSING EVALUATOR SIGNATURE: DATE: 09/06/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/06/2023
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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