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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376101215
Report Date: 04/05/2024
Date Signed: 04/05/2024 12:12:26 PM

Document Has Been Signed on 04/05/2024 12:12 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:AL DUJAILI, GHIAHIB FAMILY CHILD CAREFACILITY NUMBER:
376101215
ADMINISTRATOR/
DIRECTOR:
FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 3DATE:
04/05/2024
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:30 AM
MET WITH:Ghiahib AldujailiTIME VISIT/
INSPECTION COMPLETED:
12:40 PM
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On April 5, 2024 at 10:30 a.m., Licensing Program Analyst (LPA), Sherlynn Banas met with Licensee Ghiahib Aldujaili, for the purpose increase in capacity from eight (8) to fourteen (14) children. Haitham Alshakarchi (husband) was also present and greeted the LPA. There were no children when LPA Banas arrived at facility. Three children arrived at 11:15. Licensee has 8 children enrolled. .

LPA toured the home. There are three bedrooms and three bathrooms. All required forms were posted. There is a working telephone on the premises. There are no bodies of water or weapons/firearms or ammunition in the home or on the property. The fire extinguisher size (2A10BC or larger) meets requirements and is fully charged, located in the kitchen. The smoke detector and carbon monoxide detector is mounted on the living room wall by the entrance and is operational. Applicant’s Pediatric CPR/FA certification is valid through 5/25. She has an 18 year old daughter who lives with her and is fingerprinted. Control of property was verified today. The Fire Safety Inspection Request (STD 850) was approved by the local fire marshal and GRANTED the capacity increase to fourteen (14) children on 04/02/2024.

Applicant will be using the following areas for childcare: Living room 1, dining room, kitchen, bathroom 1 by the hallway and Child Care 1 (bedroom 3), and the fenced backyard. Off limits areas of the home is the master bedroom, which is called bedroom 1, bedroom 2, living room 2, and garage. Off limit areas has been inaccessible with the use of door knob covers. LPA discussed about the heater which was preciously not covered but will be covered according to Licensee based on regulations.
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Outdoor play area is fenced and equipped with age-appropriate play structure and toys and are in good condition. Applicant was reminded of requirements for children’s records, child abuse reporting, unusual incident reporting, immunization, criminal background clearance procedures and policies, and posting requirements.
SUPERVISORS NAME: Tashima Daniel
LICENSING EVALUATOR NAME: Sherlynn Banas
LICENSING EVALUATOR SIGNATURE: DATE: 04/05/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/05/2024
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: AL DUJAILI, GHIAHIB FAMILY CHILD CARE
FACILITY NUMBER: 376101215
VISIT DATE: 04/05/2024
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LPA reviewed the Fire drill which was last done on September 29, 2023. Three child records were reviewed.

Smoking during in or around day care areas is prohibited. Current children's records and the roster were reviewed today.

Licensee was reminded of the staffing/capacity ratios for Large Family Child Care Homes. Twelve (12) children, no more than 4 infants (birth to 24 months) and 8 older children over the age of 2. A qualified assistant (age 14 or older) is required. For fourteen (14) children, no more than 3 infants (birth to 24 months) and 11 older children; at least 2 school age, 1 child at least age 6, 1 child enrolled in and attending kindergarten or elementary school. When there isn't a qualified assistant, licensee must follow Small Family Home Child Care Regulations.

LPA discussed with Licensee the safe sleep regulations and 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. . Licensee is reminded that infants may not be swaddled while in care and walkers, exersaucers, jumpers, bouncy seats, napping portables and drop sided cribs are not permitted for use.

In case of a child getting sick, an isolation will be in the area in the living Room 1.
SUPERVISORS NAME: Tashima Daniel
LICENSING EVALUATOR NAME: Sherlynn Banas
LICENSING EVALUATOR SIGNATURE:

DATE: 04/05/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/05/2024
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: AL DUJAILI, GHIAHIB FAMILY CHILD CARE
FACILITY NUMBER: 376101215
VISIT DATE: 04/05/2024
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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, an updated Plan of Operation that includes 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.

Licensee is advised to signed up for Quarterly Updates and Provider Information Notices (PINs) for one or more programs on our website: www.ccld.ca.gov.

No deficiencies cited during today’s visit.



A license for a capacity of fourteen (14) will be issued after final file review. An exit interview was conducted. The report was reviewed with Licensee, Ghiahib Aldujaili. A notice of site visit was given and must remain posted for 30 days.
SUPERVISORS NAME: Tashima Daniel
LICENSING EVALUATOR NAME: Sherlynn Banas
LICENSING EVALUATOR SIGNATURE:

DATE: 04/05/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/05/2024
LIC809 (FAS) - (06/04)
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