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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376100991
Report Date: 03/03/2022
Date Signed: 03/03/2022 12:46:47 PM

Document Has Been Signed on 03/03/2022 12:46 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:MATY, LAKAA FAMILY CHILD CAREFACILITY NUMBER:
376100991
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 0DATE:
03/03/2022
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
10:56 AM
MET WITH:Lakaa MatyTIME COMPLETED:
01:00 PM
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On 3/3/22 at 10:56AM, Licensing Program Analyst(LPA) Nancy Diaz conducted an announced Pre-Licensing inspection for a change of location with the applicant, Lakaa Maty. Applicant's sister, Luma Mati was also present and helped translate this inspection in Arabic.

This 4-bedroom, 2-bathroom single family home was toured and inspected to ensure an environment safe for the care and supervision of children.

Applicant maintains smoke and carbon monoxide detectors and fire extinguisher in the home that meets regulation requirements. Both detectors were tested today and deemed to be operable. All hazardous items were latched and secured under the kitchen and bathroom sink and are out of reach of children. Ms. Maty stated that she does not maintain any weapons. Applicant maintains a first aid kit in the home. LPA did not observed any bodies of water.

A review of staff records on this date indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse clearances or exemptions. Applicant lives in the home with her two adult sisters Luma Mati & Lena Matte and their mother Sabeeha Shaooka. Her 10-year old niece also lives in the home. Control of property was provided to the department via copy of mortgage. First Aid and CPR will expire on October 2023 and Preventative Health Practices course was completed on 10/18/2017. Ms. Maty completed "Lead Poisoning Prevention" on 2/16/2022. . Mandated Reporter Training was waived due to limited English proficiency of applicant. Applicant's primary language is Arabic.

The daycare children will have access to: living room, dining, kitchen, hallway bathroom, bedroom #2 and back fenced yard. Applicant was reminded that she must provide visual supervision of children during activities in the backyard as the fencing does not meet regulation requirements. Off limit areas are: Master bedroom & bathroom, Bedroom #3, Bedroom #4, laundry room and garage.
SUPERVISORS NAME: Tashima Daniel
LICENSING EVALUATOR NAME: Nancy Diaz
LICENSING EVALUATOR SIGNATURE: DATE: 03/03/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/03/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 4
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: MATY, LAKAA FAMILY CHILD CARE
FACILITY NUMBER: 376100991
VISIT DATE: 03/03/2022
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LPA reviewed with applicant, Lakaa Maty the LIC 311D, Forms/Records To Keep In Your Family Child Care Homes, children’s forms/records, facility forms/records, and information to be posted.

The new provider packet was also reviewed with the applicant including information on child abuse reporting, children’s records, immunizations, adults living or working in the home, SIDS, Incidental Medical Services, and the YMCA Resource Center. Applicant was reminded that corporal punishment, smoking, walkers, exersaucers, jumpers and bouncy seats are not allowed in day care. All equipment that is used should be used only as intended by the manufacturer. LPA and Licensee discussed Shaken Baby Syndrome and California Megan's Law and LPA provided: www.meganslaw.ca.gov.
Applicant and LPA discussed COVID-19 guidelines and how to prevent spread of the virus. Applicant will post COVID-19 posters in facility. Applicant was provided COVID-19 resources and directed to website: https://www.cdss.ca.gov/inforesources/community-care-licensing to receive important updates and information.
LPA also provided the following to the applicant – COVID-19 Decision Trees for Child Care and Guidance for Child Care Providers and Programs.

Applicant has met all immunization requirements per SB792 and have completed the AB1207 Mandated Reported Training. Applicant is reminded to make anything that reads, "Keep Out of Reach of Children" inaccessible to children.

Applicant, Lakaa Maty was reminded that all adults 18 and over living in the home, persons who provide care and supervision to children, and staff who have contact with children, 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.

Applicant states that she will comply with all regulations and laws governing family child care homes and that she is financially secure to operate a family child care home for children. LPA reviewed this report with Applicant prior to obtaining her signature.
SUPERVISORS NAME: Tashima Daniel
LICENSING EVALUATOR NAME: Nancy Diaz
LICENSING EVALUATOR SIGNATURE:

DATE: 03/03/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/03/2022
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: MATY, LAKAA FAMILY CHILD CARE
FACILITY NUMBER: 376100991
VISIT DATE: 03/03/2022
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LPA discussed and provided applicant with the following: Child Care Advocates - email address childcareadvocatesprogram@dss.ca.gov and phone number (916) 654-1541.In addition, for common questions or questions regarding licensing requirements to contact the Child Care Licensing duty line at 619-767-2248.

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

LPA discussed the safe sleep regulations with applicant, Lakaa Maty 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 [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.

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platform.
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: Tashima Daniel
LICENSING EVALUATOR NAME: Nancy Diaz
LICENSING EVALUATOR SIGNATURE:

DATE: 03/03/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/03/2022
LIC809 (FAS) - (06/04)
Page: 3 of 4
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: MATY, LAKAA FAMILY CHILD CARE
FACILITY NUMBER: 376100991
VISIT DATE: 03/03/2022
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An exit interview was conducted with the applicant. A copy of this report and appeal rights were provided.

The following corrections are needed prior to licensure:
- Post required documents on the wall.
- Post COVID19 information on the wall.
- Update form LIC 999A to reflect rooms in the home that was not included in the original submitted form - Laundry room and Bathroom in the Master Bedroom. Post updated form and submit a copy to LPA.

*Applicant paid overdue annual fee for former License #376627274 during the inspection (online).

Applicant will contact this LPA and submit proof of corrections via email to: Nancy.Diaz@dss.ca.gov
SUPERVISORS NAME: Tashima Daniel
LICENSING EVALUATOR NAME: Nancy Diaz
LICENSING EVALUATOR SIGNATURE:

DATE: 03/03/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/03/2022
LIC809 (FAS) - (06/04)
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