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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376101488
Report Date: 05/18/2023
Date Signed: 05/18/2023 04:45:01 PM

Document Has Been Signed on 05/18/2023 04:45 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:WARSHAN, MARIAM FAMILY CHILD CAREFACILITY NUMBER:
376101488
ADMINISTRATOR:MARIAM WARSHANFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(619) 635-8059
CITY:LAKESIDESTATE: CAZIP CODE:
92040
CAPACITY: 14TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
05/18/2023
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Licensee, Mariam Warshan TIME COMPLETED:
10:30 AM
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Licensing Program Analyst (LPA), Jennifer Lott, conducted an announced Pre-Licensing/Change of Location Inspection. LPA was greeted at the front door by Licensee, Mariam Warshan and granted entry after identifying herself and disclosing the purpose of her visit. Daughter, Anisa Warshan provided translating service. The applicant has applied for a capacity of fourteen (14) . The home consists of five (5) bedrooms and three (3) bathrooms. The applicant will be using the following areas for daycare: Living room #1, kitchen, living room #2, bathroom #1, backyard. Off limit areas include: all upstairs, garage, front yard, upper yard, jacuzzi, bedroom #1, and laundry room. Outdoor play area is fenced/locked.

The home has a functioning carbon monoxide / smoke detector and fire extinguisher that meet statutory requirements. The fireplace is screened to prevent access by children. Storage areas for poisons, detergents, cleaning solutions, medications and items which state keep out of reach of children have been locked and inaccessible to children. There is a jacuzzi located in the backyard which is surrounded by a 5 ft fence and is padlocked to make the jacuzzi inaccessible. The jacuzzi is off limits. Licensee agrees the fencing will remain in place and properly functioning/locked whenever there are licensed children in care.

Applicant, Warshan advised there are no firearms or ammunition stored on the premises. The home is kept clean with heating and ventilation for safety and comfort. Where children less than 5 years old are in care, stairs are fenced and/or barricaded. The home provides safe toys, play equipment and materials. The applicant has completed training on preventative health practices including pediatric CPR and First Aid. Staff immunization were reviewed and in compliance. There is a working phone and email address.
SUPERVISORS NAME: Tashima Daniel
LICENSING EVALUATOR NAME: Jennifer Lott
LICENSING EVALUATOR SIGNATURE: DATE: 05/18/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/18/2023
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 3
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: WARSHAN, MARIAM FAMILY CHILD CARE
FACILITY NUMBER: 376101488
VISIT DATE: 05/18/2023
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The new provider packet was reviewed with the applicant including information on immunizations, child abuse reporting, car seat laws, shaken baby syndrome, SIDS,and the effects of lead poisoning. Applicant was also reminded that corporal punishment, smoking, walkers, exersaucers, jumpers and bouncy seats shall not be permitted during daycare operation. All equipment that is used should be used only as intended by the manufacturer. Applicant Warshan states they are aware that interference with a child’s daily functions, physical or mental abuse and corporal punishment is not permitted. LPA and applicant discussed California Megan’s Law and LPA provided the link www.meganslaw.ca.gov.

LPA discussed safe sleep regulations with the applicant, 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 the applicant 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 CPSC to be notified of any recalls on their purchased equipment.

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.

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 minimum/day up to $500 maximum per day/per person will be assessed if the regulation is violated.
SUPERVISORS NAME: Tashima Daniel
LICENSING EVALUATOR NAME: Jennifer Lott
LICENSING EVALUATOR SIGNATURE:

DATE: 05/18/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/18/2023
LIC809 (FAS) - (06/04)
Page: 2 of 3
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: WARSHAN, MARIAM FAMILY CHILD CARE
FACILITY NUMBER: 376101488
VISIT DATE: 05/18/2023
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LPA reviewed with applicant, 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.

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: http://www.ada.gov/childqanda.htm

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.

No corrections are needed at this time. A license for fourteen (14) will be granted upon final file review. Applicant agrees to comply with all regulations and laws governing Family Child Care Homes. Additional Technical Assistance was provided and noted on the attached Advisory Note – Technical Assistance (LIC 9102).

Exit interview conducted and report was reviewed with Applicant, Warshan.
SUPERVISORS NAME: Tashima Daniel
LICENSING EVALUATOR NAME: Jennifer Lott
LICENSING EVALUATOR SIGNATURE:

DATE: 05/18/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/18/2023
LIC809 (FAS) - (06/04)
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