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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376102121
Report Date: 02/06/2025
Date Signed: 02/06/2025 01:21:06 PM

Document Has Been Signed on 02/06/2025 01:21 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:NOORI, SHAFIQA FAMILY CHILD CAREFACILITY NUMBER:
376102121
ADMINISTRATOR/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 0DATE:
02/06/2025
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:43 PM
MET WITH:Shafiqa & Siraj NooriTIME VISIT/
INSPECTION COMPLETED:
01:30 PM
NARRATIVE
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On 2/6/2025 @ 12:43PM, Licensing Program Analyst (LPA) Nancy Diaz conducted an unannounced case management inspection. LPA was allowed entry by licensee's husband, Siraj Noori. Mrs. Noori arrived shortly thereafter. The purpose of this inspection is in reference to Mrs. Noori's application for an increase of capacity to 14 children. A copy of the landlord consent is on file. Fire Marshall clearance was received from the Heartland Fire & Rescue on 1/14/2025.

A tour of the home was conducted with Mr. & Mrs. Noori. Children will have access to the following areas:
Living room, kitchen, dining, hallway bathroom and back fenced yard. Mrs. Noori stated that she does not maintain weapons in the home. LPA did not observed bodies of water within the premises.

Type B deficiency was cited today. Type B deficiency if not corrected poses a potential risk to the health, safety or personal rights of clients in care.

Exit interview was conducted with Mrs. Noori. LPA reviewed and provided a copy of this report with Mrs. Noori. A copy of the appeal rights was also given. Notice of site visit was provided and posted.
SUPERVISORS NAME: Joelle Redding
LICENSING EVALUATOR NAME: Nancy Diaz
LICENSING EVALUATOR SIGNATURE: DATE: 02/06/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/06/2025
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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Document Has Been Signed on 02/06/2025 01:21 PM - It Cannot Be Edited


Created By: Nancy Diaz On 02/06/2025 at 01:09 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: NOORI, SHAFIQA FAMILY CHILD CARE
FACILITY NUMBER: 376102121

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/06/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/13/2025
Section Cited
CCR
102417(g)

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OPERATION OF A FAMILY CHILD CARE HOME. The home shall be free from defects or conditions which might endanger a child.

This requirement was not met as evidenced by:
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Mr. Noori stated that he will have a maintenance person build a permanent gate to keep the side yard inaccessible to children.
Mrs. Noori will submit photo to the department no later than 2/13/2025 to show that the gate was built and that the construction materials were removed from the back yard.
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Based on observation, licensee's sideyard is accessible to children. LPA observed that construction material were stored in the sideyard. LPA also observed construction material accessible to children in the back of the yard. Licensee currently has her bar-b-que grill blocking the area, however this is temporary.
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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:Nancy Diaz
LICENSING EVALUATOR SIGNATURE:
DATE: 02/06/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/06/2025


LIC809 (FAS) - (06/04)
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