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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376101136
Report Date: 06/15/2022
Date Signed: 06/15/2022 12:32:36 PM

Document Has Been Signed on 06/15/2022 12:32 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:ALAWAD, MAJDOLEEN FAMILY CHILD CAREFACILITY NUMBER:
376101136
ADMINISTRATOR:MAJDOLEEN ALAWADFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(916) 595-4998
CITY:EL CAJONSTATE: CAZIP CODE:
92021
CAPACITY: 14TOTAL ENROLLED CHILDREN: 0CENSUS: 4DATE:
06/15/2022
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
10:50 AM
MET WITH:Majdoleen AlawadTIME COMPLETED:
12:40 PM
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On 06/15/2022 at 10:50am, Licensing Program Analyst (LPA) Selina Siao conducted a change of location Pre-Licensing with the applicant and her high school daughter D. Alawad assist with translation in Arabic. Present at the home today includes applicant, her husband and four daughters that are minors. The 4 bedroom, 2.5 bath gated community home was toured and inspected to ensure an environment safe for the care and supervision of children. The home has a fire extinguisher size 3A40BC, smoke and carbon monoxide detector that are all operating and meets the departments requirements. All hazardous items were latched/locked and secured out of reach of children. There are no bodies of water or weapons in the home. Applicant's EMSA approved CPR and First Aid cards are current due to expire on 08/2023 and she is registered to take the 8 hours preventative health practice course on 06/23/2022. A review of staff records on this date indicates that applicant and her husband are the current adults that lives at the home has the required immunization and background clearances. Applicant and her husband owns the property and provided proof of control of the property to the department.

Applicant will be using the downstairs areas of the home for childcare: living room #1, dining area, living room #2 and 1/2 bath #3. Off limit areas includes: kitchen, garage and all of upstairs. There is a safety gate to block off the kitchen and upstairs. The home has some toys and equipment available for children. The outdoor area will be the facility's backyard and visual supervision is required when children are outside.
LPA discussed the following information to applicant: children’s records, unusual incident reporting, immunization, shaken baby syndrome, SIDS, car seat law, healthy beverage and heat related illness information was provided to applicant. Applicant was also
SUPERVISORS NAME: Monica Cuddy
LICENSING EVALUATOR NAME: Selina Siao
LICENSING EVALUATOR SIGNATURE: DATE: 06/15/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/15/2022
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
CCLD Regional Office, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME: ALAWAD, MAJDOLEEN FAMILY CHILD CARE
FACILITY NUMBER: 376101136
VISIT DATE: 06/15/2022
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reminded that corporal punishment, smoking, walkers, exersaucers, bouncy seats and jumpers are not allowed in day care. The ABC’S of Safe Sleep: Sleep is Safest: Alone, on their Back in an empty Crib on a firm mattress.

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

Applicant shall comply with all regulations and laws governing family childcare homes and be financially secure to operate a family childcare home for children.

Applicant 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.

LPA discussed California Megan's Law and provided: www.meganslaw.ca.gov.

All unusual incident reports shall be submitted to Licensing office via email at SDIncidentReports@dss.ca.gov or via fax at (619)767-2203.

The home has been approved for a large license by the fire department on 06/06/2022.

The following correction is needed prior to granting a provisional license valid for 90 days.
  • All the outlet covers downstairs needs to have outlet covers

Applicant shall submit a video of the correction to LPA within 5 days no later than 06/20/2022.
This report has been translated to applicant by her oldest daughter in Arabic.
SUPERVISORS NAME: Monica Cuddy
LICENSING EVALUATOR NAME: Selina Siao
LICENSING EVALUATOR SIGNATURE:

DATE: 06/15/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/15/2022
LIC809 (FAS) - (06/04)
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