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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376101281
Report Date: 07/22/2024
Date Signed: 07/22/2024 03:06:24 PM

Document Has Been Signed on 07/22/2024 03:06 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 N. CC RO, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME:GAD, BRIKSAM FAMILY CHILD CAREFACILITY NUMBER:
376101281
ADMINISTRATOR/
DIRECTOR:		BRIKSAM GADFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(786) 440-3746
CITY:EL CAJONSTATE: CAZIP CODE:
92021
CAPACITY: 14TOTAL ENROLLED CHILDREN: 6CENSUS: 2DATE:
07/22/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:20 PM
MET WITH:Brisam GadTIME VISIT/
INSPECTION COMPLETED:
03:20 PM
NARRATIVE
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On 07/22/24 at 12:20 PM, Licensing Program Analyst (LPA) Gerald Poindexter conducted an unannounced inspection. Upon arrival, LPAsmet with Licensee, Briksam Gad. The two-story home contains four (4) bedroom and three (3) bathrooms, plus a second-floor loft, laundry room and garage. LPA toured and inspected all childcare areas to ensure an environment safe for the care and supervision of children. Present were the Licensee and one daycare child. Also present were two of the licensees minor children, her minor nephew, and her adult sister/helper, Jazmine Gad. Proper supervision and ratios were observed.

Licensee has provided adequate space for the children to eat, sleep and play within the home. Areas used for child care include: Kitchen, living room, dining room, downstairs bathroom, backyard, upstairs will use bathroom #2 and the loft area. Off limit areas include: Front yard, garage, upstairs to include bedrooms #1, #2, #3, #4 and laundry room. There is a pantry located in the kitchen, which has a doorknob cover. The garage door is locked. There is a working phone and email address at the facility. The licensee has sufficient age appropriate, safe, toys and equipment available. The home was observed to be clean and orderly, with sufficient heating and ventilation for safety and comfort. Licensee stated she uses the fenced in backyard for outdoor activities. LPA advised that during outdoor play, visual supervision is required at all times.

No guns or weapons present as stated by the Licensee. The home has a fully charged fire extinguisher, carbon monoxide detector, and smoke detector that meet requirements and are operational. The living room fireplace is screened. Poisons, cleaning compounds, medications and other hazardous items were not made inaccessible to children at the time of inspection. Inaccessibility of hazardous items via latches/locks must be constantly reassessed depending on the children in care. Licensee is reminded to ensure anything that reads "Keep out of reach of children" is inaccessible to children. CONTINUED ON PAGE 2

SUPERVISORS NAME: Joelle Redding
LICENSING EVALUATOR NAME: Gerald Poindexter
LICENSING EVALUATOR SIGNATURE: DATE: 07/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/22/2024
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 N. CC RO, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME: GAD, BRIKSAM FAMILY CHILD CARE
FACILITY NUMBER: 376101281
VISIT DATE: 07/22/2024
NARRATIVE
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LPA observed all required postings were posted. Children’s and Staff records were reviewed. Licensee has the required immunizations per SB792. Licensee’s CPR/First Aid expires 1/25 and helpers Jazmine Gad and Fadila El Shanawani CPR/First Aid expires 2/25 and 7/25, respectively. Preventative health practices course was completed, which includes lead poison prevention training. Licensee’s Mandated Reporter Training certificate expires 11/29/24. Helpers’ certificates expire 12/2/24. LPA reminded the licensee that Mandated Reporter Training certificates must be renewed every two years.

Emergency drills were not conducted. LPA advised the licensee of the difference between emergency drills and testing fire alarms. 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. 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 Mary Medina 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.



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/.
CONTINUED ON PAGE 3
SUPERVISORS NAME: Joelle Redding
LICENSING EVALUATOR NAME: Gerald Poindexter
LICENSING EVALUATOR SIGNATURE:

DATE: 07/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/22/2024
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 N. CC RO, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME: GAD, BRIKSAM FAMILY CHILD CARE
FACILITY NUMBER: 376101281
VISIT DATE: 07/22/2024
NARRATIVE
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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.



Exit interview conducted and report was reviewed with the licensee Briksam Gad. 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: Joelle Redding
LICENSING EVALUATOR NAME: Gerald Poindexter
LICENSING EVALUATOR SIGNATURE:

DATE: 07/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/22/2024
LIC809 (FAS) - (06/04)
Page: 3 of 5
Document Has Been Signed on 07/22/2024 03:06 PM - It Cannot Be Edited


Created By: Gerald Poindexter On 07/22/2024 at 02:16 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: GAD, BRIKSAM FAMILY CHILD CARE
FACILITY NUMBER: 376101281

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/22/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102417(g)(4)
Operation of A Family Child Care Home
(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (4) Poisons, detergents, cleaning compounds, medicines, firearms and other items which could pose a danger if readily available to children shall be stored where they are inaccessible to children.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on LPA observation, licensee left accessible: medication, incense packages, and cigarette lighters in two unlatched, kitchen drawers, which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 07/22/2024
Plan of Correction
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Upon advice of the LPA, the licensee removed all unsafe items from the drawers. LPA advised that latches be installed on the drawers or that such items be moved to locked areas only. Deficiency cleared on site.
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:Joelle Redding
LICENSING EVALUATOR NAME:Gerald Poindexter
LICENSING EVALUATOR SIGNATURE:
DATE: 07/22/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/22/2024


LIC809 (FAS) - (06/04)
Page: 4 of 5
Document Has Been Signed on 07/22/2024 03:06 PM - It Cannot Be Edited


Created By: Gerald Poindexter On 07/22/2024 at 02:16 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: GAD, BRIKSAM FAMILY CHILD CARE
FACILITY NUMBER: 376101281

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/22/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102417(g)(9)(A)1
Operation of A Family Child Care Home
(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (9) Each family child care home shall have a written disaster plan of action prepared on a form approved by the Department. All children, age and ability permitting, and the provider, the assistant provider, and other members of the household, shall be instructed in their duties under the disaster plan. As their age and ability permit, newly enrolled children shall be informed promptly of their duties as required in the plan. (A) Each family child care home shall conduct fire drills and disaster drills at least once every six months. 1. The licensee shall document the drills, including the date and time of each drill. This documentation shall kept at the family child care home.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on licensee statement and LPA review of facility records, the licensee has not performed a fire drill every 6 months as required and was unfamiliar the difference between conducting emergency drills vs. testing fire alarms. This poses a potential safety risk to children in care.
POC Due Date: 08/05/2024
Plan of Correction
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LPA explained options for emergency drills and that they must be documented on the Emergency Drill Log every 6 months. Licensee stated they will conduct an emergency drill no later than 8/5/24. The licensee will email a photo or video documentation to LPA via by POC date.

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:Joelle Redding
LICENSING EVALUATOR NAME:Gerald Poindexter
LICENSING EVALUATOR SIGNATURE:
DATE: 07/22/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/22/2024


LIC809 (FAS) - (06/04)
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