376100700-7-11-2023-51-CC-GPOR-CTMV6M-20230711160945

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 376100700
Report Date: 07/11/2023
Date Signed: 07/11/2023 04:09:52 PM

Document Has Been Signed on 07/11/2023 04:09 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
SAN DIEGO NORTH, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108

FACILITY NAME:	SHAMOON, WARDYAH FAMILY CHILD CARE		FACILITY NUMBER:	376100700
ADMINISTRATOR:	WARDYAH SHAMOON		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(619) 873-6993
CITY:	EL CAJON	STATE: CA	ZIP CODE:	92020
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS: 1	DATE:	07/11/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	02:50 PM
MET WITH:	Wardyah Shamoon		TIME COMPLETED:	04:20 PM

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On 7/11/23 at 2:50 pm Licensing Program Analyst (LPA) Gerald Poindexter and LPA Adrian Mangina conducted an unannounced annual inspection. Upon arrival, LPAs met with Licensee Wardyah Shamoon. Also, in the home were licensee's two minor children and Maryam Galo, the licensee’s daughter, and helper, who translated from Arabic. Licensee was provided the Inspection Checklist (LIC 126). The four-bedroom, two- bathroom, single-story home was toured and inspected to ensure an environment safe for the care and supervision of children. Present in the home was one day care child. Licensee states that children arrive variably in the morning and afternoon, as necessary.

Licensee has provided adequate space for the children to eat, sleep and play within the home. Areas Licensee stated she uses for childcare include the following areas: living room 1, living room 2, kitchen, dining area, hallway, hall bathroom, bedroom 1, and bedroom 2. Off limit areas include: bedroom 3, bedroom 4, patio, and attached garage. Off limit areas have been made inaccessible with the use of safety gates and/or doorknob covers. LPA reminded the licensee that doorknob covers and latches should be in place whenever children are present. There are no stairs in the home. The facility has sufficient toys and equipment available.

The home has a fenced backyard/patio that is off limits and made inaccessible by a locked door. Licensee stated she utilizes a nearby park for outdoor activities and understands that direct visual observation must be maintained at all times during outdoor play. No bodies of water were observed during time of inspection.

There is a fully charged fire extinguisher, smoke and carbon monoxide detector that meet requirements and are operational. Fireplace is properly screened. Poisons, cleaning compounds, medications and other hazardous items are inaccessible to children via latched cabinets. LPA reminded the licensee that latches should be in place whenever children are present. Adequate heating and ventilation are provided. There is a working telephone. Licensee stated there are NO weapons. -- CONTINUED ON PAGE 2

SUPERVISORS NAME: Renesha Askew
LICENSING EVALUATOR NAME: Gerald Poindexter
LICENSING EVALUATOR SIGNATURE:	DATE: 07/11/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/11/2023

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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN DIEGO NORTH, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108

FACILITY NAME: SHAMOON, WARDYAH FAMILY CHILD CARE	FACILITY NUMBER: 376100700
	VISIT DATE: 07/11/2023

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LPA observed all required postings were posted. Personnel records were reviewed. Children’s and Staff records were reviewed and found to be in order. Licensee has the required immunizations per SB792. Licensee’s Pediatric CPR/First Aid are current with an expiration date of June 2024. Preventative health practices course was completed on 3/16/16. Licensee is exempt from Mandated Reporter AB1207 training certification due to having limited English proficiency, Licensee’s primary language is Arabic. Licensee’s helper, Ms. Galo’s Pediatric CPR/First Aide expires March 2024. Her Mandated Reporter certification expires 1/18/25.

Emergency drills are conducted and documented with the last one being on 3/30/23. Licensee maintains a current roster of the children which LPA obtained during time of inspection. LPA verified that all adults living or working in the home have been fingerprint cleared and associated. Licensee maintains and updates all required records for children in care. LPA reminded Licensee that all unusual incident reports shall be submitted to Licensing office via email at SDIncidentReports@dss.ca.gov or via fax at (619)767-2203. Duty officer number is (619)767-2248.

Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 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 conducted child care quality management staff interview with the Licensee.

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-andresources/safe-sleep as an additional resource. LPA also informed licensee [or facility representative] 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.

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SUPERVISORS NAME: Renesha Askew
LICENSING EVALUATOR NAME: Gerald Poindexter
LICENSING EVALUATOR SIGNATURE:	DATE: 07/11/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/11/2023

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
SAN DIEGO NORTH, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108

FACILITY NAME: SHAMOON, WARDYAH FAMILY CHILD CARE	FACILITY NUMBER: 376100700
	VISIT DATE: 07/11/2023

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Incidental Medical Services (IMS) policy was discussed. For IMS 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/.

Licensee was informed of the MyChildCarePlan.org website; 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.

To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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/inspection-process.

No deficiencies cited.

Exit interview conducted and report was reviewed with the licensee, Wardyah Shamoon. During the exit interview, the licensee, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

A notice of site visit was given and must remain posted for 30 days.

SUPERVISORS NAME: Renesha Askew
LICENSING EVALUATOR NAME: Gerald Poindexter
LICENSING EVALUATOR SIGNATURE:	DATE: 07/11/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/11/2023

LIC809 (FAS) - (06/04)

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