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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376101108
Report Date: 08/17/2023
Date Signed: 08/17/2023 04:50:10 PM

Document Has Been Signed on 08/17/2023 04:50 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:ALAWAD, SHAHA FAMILY CHILD CAREFACILITY NUMBER:
376101108
ADMINISTRATOR:SHAHA ALAWADFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(619) 569-8245
CITY:EL CAJONSTATE: CAZIP CODE:
92021
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 0DATE:
08/17/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:15 PM
MET WITH:Shaha AlawadTIME COMPLETED:
05:15 PM
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On 8/17/23 at 12:15 am Licensing Program Analyst (LPA) Gerald Poindexter conducted an unannounced annual inspection. Upon arrival, LPA met with Licensee Shaha Alawad. Also, in the home was Faisal Alawad (father), Sabah Alawad (mother/assistant), Anwar Alawad, (sister) and Daleen Alawad (cousin, who provided translation from Arabic). At approximately 1:56 pm the licensee’s brother, Bilal Alawad arrived with his minor son. Two day care children arrived at approximately 2:30 pm; four more children arrived at 3:54 pm. Licensee was provided the Inspection Checklist (LIC 126). The four-bedroom, three-bathroom, two-story home was toured and inspected to ensure an environment safe for the care and supervision of children.

Licensee has provided adequate space for the children to eat, sleep and play within the home. Areas Licensee stated she uses for childcare include downstairs living room, and kitchen. Bathroom in located down in basement. Off limits areas include entire upstairs, backyard, and garage which are inaccessible through use of doorknob cover and door locks (patio door leading to backyard). There are stairs in the home. Stairs are barricaded when children under age 5 years old are present. The facility has sufficient toys and equipment available.

The home has a fenced backyard available for outdoor activities, but the licensee states it is off limits to day care children. 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. There is a hot tub in the backyard which has a locking cover that can hold the weight of an adult. Licensee states that neither backyard nor the hot tub will not be used for children in care.

There is a fully charged fire extinguisher, smoke and carbon monoxide detector that meet requirements and are operational. Fireplace is screened and also inaccessible to children via floor cushions. Poisons, cleaning compounds, medications and other hazardous items were not immediately inaccessible upon inspection, but were made so during the inspection through the use of drawer and cabinet latches. Adequate heating and ventilation are provided. There is a working telephone. Licensee stated there are NO firearms and weapons in the home. ...CONTINUED ON PAGE 2

SUPERVISORS NAME: Renesha Askew
LICENSING EVALUATOR NAME: Gerald Poindexter
LICENSING EVALUATOR SIGNATURE: DATE: 08/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/17/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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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: ALAWAD, SHAHA FAMILY CHILD CARE
FACILITY NUMBER: 376101108
VISIT DATE: 08/17/2023
NARRATIVE
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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 incomplete. Licensee has the required immunizations per SB792. Licensee’s Pediatric CPR/First Aid are current with an expiration date of 9/2023. Licensee assistant’s First Aid and CPR expires 1/2025. Applicant and assistant are exempt from Mandated Reporter Training AB 1207, as primary language is Arabic. Staff immunization requirements per SB792 were met and TB requirements were met.

Emergency drills are conducted and documented with the last one being on 5/11/22. Licensee maintains current roster (digital) which LPA obtained during time of inspection. LPA advised to maintain printed roster as backup. LPA verified that all adults living or working in the home have been fingerprint cleared and associated with the exception of cousin, Daleen Alawad. 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 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: 08/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/17/2023
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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: ALAWAD, SHAHA FAMILY CHILD CARE
FACILITY NUMBER: 376101108
VISIT DATE: 08/17/2023
NARRATIVE
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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.

See LIC809D for deficiencies cited.



Type A Citation
LPA Gerald Poindexter informed licensee Shaha Alawad that this report dated 8/17/23 documents one (1) Type A citation which shall be posted for 30 consecutive days as there is immediate risk(s) to the health, safety, or personal rights of children in care.

Also, LPA Gerald Poindexter informed the licensee Shaha Alawad to provide a copy of this licensing report dated 8/17/23 that documents a Type A citation to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

...CONTINUED ON PAGE 4
SUPERVISORS NAME: Renesha Askew
LICENSING EVALUATOR NAME: Gerald Poindexter
LICENSING EVALUATOR SIGNATURE:

DATE: 08/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/17/2023
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: ALAWAD, SHAHA FAMILY CHILD CARE
FACILITY NUMBER: 376101108
VISIT DATE: 08/17/2023
NARRATIVE
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Civil Penalty
Please be advised that FAILURE TO PAY the required civil penalty payment may result in in the REVOCATION OF YOUR LICENSE. You must respond within 30 days with the payment of or a proposed payment plan that includes the first payment. Further, the Department will not approve any requests for increase in capacity or for additional capacity of additional licenses while civil penalties remain unpaid.

Exit interview conducted and report was reviewed with the licensee Shaha Alawad. 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: 08/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/17/2023
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 08/17/2023 04:50 PM - It Cannot Be Edited


Created By: Gerald Poindexter On 08/17/2023 at 03:10 PM
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: 376101108

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/17/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
HSC
102370
102370 Criminal Record Clearance - All individuals subject to a criminal record review... shall prior to working, residing, or volunteering in a licensed facility:(1) Obtain a California clearance or a criminal record. This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observaton and statement from the licensee to the LPA, the licensee's cousin turned 18 years old more than six months ago (DOB:1/1/05)) and has not submitted fingerprints for a background clearance, and continues to reside in the home, which poses an immediatel health and safety risk to children in care.
POC Due Date: 08/18/2023
Plan of Correction
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Licensee states she will have cousin submit for fingerprints and provide proof by no later than close of business 8/18/23. Licensee will ensure required fingerprinting for any future adults, or child upon their 18th birthday, prior to working or residing in the home, receive criminal background clearances.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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:Renesha Askew
LICENSING EVALUATOR NAME:Gerald Poindexter
LICENSING EVALUATOR SIGNATURE:
DATE: 08/17/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/17/2023


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Document Has Been Signed on 08/17/2023 04:50 PM - It Cannot Be Edited


Created By: Gerald Poindexter On 08/17/2023 at 03:39 PM
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: 376101108

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/17/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
102417(g)9)(a)(1)
Operation of a Family Child Care Home -... Each family child care home shall conduct fire drills and disaster drills at least once every six months. The licensee shall document the drills, including the date and time of each drill. This documentation shall be kept at the family child care home. This requirement is not met as evidenced by:
:
Deficient Practice Statement
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Based on LPA's observations and review of facility records, licensee has not performed or documented a fire drill every 6 months as required. This poses a potential safety risk to children in care.
POC Due Date: 09/01/2023
Plan of Correction
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Licensee states they will perform the required fire drill and document it as required. Licensee will send a photo of the documentation to LPA via email or fax by POC date.
Type B
Section Cited
CCR
10242(a-e)
Child's Records - ...The licensee shall maintain, in each child's record, the signed and dated notice form required...This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on LPA's record review, 9 of 9 enrolled children had incomplete records; All of the children’s records missing a parent/guardian's signature to and required licensing forms;. This poses a potential safety risk to children in care.
POC Due Date: 09/01/2023
Plan of Correction
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Licensee states they will complete children’s records by obtaining signatures on all required licensing forms and submit proof of signatures to LPA by POC date via email.
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:Renesha Askew
LICENSING EVALUATOR NAME:Gerald Poindexter
LICENSING EVALUATOR SIGNATURE:
DATE: 08/17/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/17/2023


LIC809 (FAS) - (06/04)
Page: 6 of 7
Document Has Been Signed on 08/17/2023 04:50 PM - It Cannot Be Edited


Created By: Gerald Poindexter On 08/17/2023 at 03:51 PM
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: 376101108

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/17/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102419(d)
(d) At the time of acceptance of each child into care, the licensee shall provide the child's parent or authorized representative with a copy of the notice Family Child Care Home Notification of Parent's Rights, LIC 995A (8/06), the Caregiver Background Check Process, LIC 995E (6/05), and the Family child Care Consumer Awareness Information, LIC 9212 (10/05). This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on records review and interview, Licensee stated they have no children's records on file for 4 out of 9 children
POC Due Date: 09/01/2023
Plan of Correction
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Licensee stated they will have the parents complete all the children's enrollment documents and send proof to LPA by by POC date via email.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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:Renesha Askew
LICENSING EVALUATOR NAME:Gerald Poindexter
LICENSING EVALUATOR SIGNATURE:
DATE: 08/17/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/17/2023


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