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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376102959
Report Date: 10/31/2025
Date Signed: 10/31/2025 12:38:52 PM

Document Has Been Signed on 10/31/2025 12:38 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:HASHIMI, BIBI FATEMA FAMILY CHILD CAREFACILITY NUMBER:
376102959
ADMINISTRATOR/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
10/31/2025
TYPE OF VISIT:PrelicensingANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:57 AM
MET WITH:Bibi Fatema HashimiTIME VISIT/
INSPECTION COMPLETED:
01:00 PM
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On 10/31/2025 at 8:57am Licensing Program Analyst (LPA) Jody Dye conducted an announced Change of Location inspection for the applicant. Upon arrival, LPA was greeted by applicant, Bibi Fatema Hashimi and was granted entry after showing badge, identifying self, and stating the reason for the visit. LPA provided an entrance checklist to the applicant. LPA observed one other adult identified as the applicants Husband Mohammad Faqiri and no minor children present in the home at the time of the visit. The applicants husband Mohammad Faqiri assisted with translation during the home inspection, review of LIC 311D Forms to keep in your childcare, review of the report, and exit interview with the applicant. The three- bedroom and two-bathroom one-story home was toured and inspected to ensure an environment safe for the care and supervision of children.

The fire extinguisher (2A:10BC) located in the kitchen, and smoke detector located in the hall are operational and meet requirements. There was no working carbon monoxide detector in the facility. All hazardous items were latched/locked and secured out of reach of children. There are no bodies of water in the home. The fireplace is screened and is not accessible to children. There is a working phone at the facility. Applicant states that there are no weapons in the home. Applicant states that they have sufficient financial resources to sustain the license.





Continued on 809-C page 2
NAME OF LICENSING PROGRAM MANAGER: Renesha Askew
NAME OF LICENSING PROGRAM ANALYST: Jody Dye
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 10/31/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/31/2025
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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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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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: HASHIMI, BIBI FATEMA FAMILY CHILD CARE
FACILITY NUMBER: 376102959
VISIT DATE: 10/31/2025
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Applicant will be using the following rooms for childcare: Bedroom #2, bedroom #3, bathroom #2, living room/hall, and backyard. Off-limits areas include Bedroom #1, bathroom #1, and laundry room and are made inaccessible using child safety doorknob covers. The garage will also be off limits and is kept inaccessible using a child safety doorknob cover on the door handle leading from the home into the garage. The accessible bedroom windows are low to the ground and have twist locks placed on the track making the windows inaccessible. The living room window had a broken latch and a twist lock was placed making it inaccessible. The applicant has a (fully fenced) backyard available for outdoor activities. The outer wall of the backyard is at a low level of 4.5 ft high in some areas. The entry/exit gates on both sides of the yard have child safety proof locks making them inaccessible. There is a large storage building in the back yard that is separate from the home. This building had broken glass in the window accessible to children. This will be off-limits to children and is made inaccessible using a child proof safety lock. The applicant will always provide visual supervision when children are outdoors. The applicant has sufficient toys and play equipment available.

Current CPR and First Aid certification expires on 10/20/2027. Preventative Health Practices course was completed on 11/02/2023. Applicant is exempt from the mandated reporter requirement due to English not being their primary language. Immunization requirements per SB792 were met. Required documents have been posted.


The applicant provided proof of control of property. Because the applicant rents/leases the home, proof of landlord notification is required. The LPA observed the Property Owner/Landlord Notification form (LIC9151) that the applicant confirms was provided to the property owner/landlord. The applicant obtained a signed Property Owner/Landlord Consent form (LIC 9149).


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, 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.

Continued on LIC 809-C Page 3
NAME OF LICENSING PROGRAM MANAGER: Renesha Askew
NAME OF LICENSING PROGRAM ANALYST: Jody Dye
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 10/31/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/31/2025
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: HASHIMI, BIBI FATEMA FAMILY CHILD CARE
FACILITY NUMBER: 376102959
VISIT DATE: 10/31/2025
NARRATIVE
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On this date, 10/31/2025, the California Attorney General - Megan’s Law website was searched for information on sex offenders required to register with local law enforcement under California's Megan's Law. No registered sex offenders were found at the facility addresses. Under state law, some registered sex offenders are not subject to public disclosure; therefore, they may not have been included in this search. However, the Department conducts a monthly cross reference of each address on record for all registered sex offenders against all CCLD facility addresses pursuant to information shared by California DOJ.


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. Entrance Checklist was provided to the applicant.

The new provider packet was reviewed with the applicant including information on child abuse and unusual incident reporting. Additional items were reviewed including, but not limited to, information on ratios and capacity, immunizations, adults living or working in the home, car seat law, shaken baby syndrome, SIDS, effects of lead poisoning, and the YMCA Resource Center. Applicant was reminded that corporal punishment, smoking, walkers, exersaucers, jumpers, and bouncy seats are not allowed in day care. All equipment that is used should be used only as intended by the manufacturers. All equipment shall be appropriate for the age level served.


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) or (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.





Continued on LIC 809-C page 4
NAME OF LICENSING PROGRAM MANAGER: Renesha Askew
NAME OF LICENSING PROGRAM ANALYST: Jody Dye
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 10/31/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/31/2025
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: HASHIMI, BIBI FATEMA FAMILY CHILD CARE
FACILITY NUMBER: 376102959
VISIT DATE: 10/31/2025
NARRATIVE
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LPA discussed the safe sleep regulations with applicant 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 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 the CPSC to be notified of any recalls on their purchased equipment.


LPA discussed and provided Licensee with the following: Child Care Advocate email address: childcareadvocatesprogram@dss.ca.gov . In addition, for general questions or questions regarding licensing requirements contact the Child Care Licensing Duty Line at (619) 767-2248.


Applicant was informed of the MyChildCarePlan.org site, 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.


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 platforms. To receive important licensed related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-carelicensing/subscribe and select the Child Care option to receive email communication.






Continued on LIC 809-C page 5
NAME OF LICENSING PROGRAM MANAGER: Renesha Askew
NAME OF LICENSING PROGRAM ANALYST: Jody Dye
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 10/31/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/31/2025
LIC809 (FAS) - (06/04)
Page: 5 of 6
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: HASHIMI, BIBI FATEMA FAMILY CHILD CARE
FACILITY NUMBER: 376102959
VISIT DATE: 10/31/2025
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The following corrections are needed prior to the issuance of the license:

1. A working carbon dioxide detector must be available in the home and meet regulation.
2. Broken glass in an outdoor storage building window that is accessible to children must be made safe.

Applicant understands that proof of corrections must be submitted to Licensing within 30 days, or the application may be denied. Applicant agreed to comply with all regulations and laws governing family child-care homes.


Exit interview conducted and report was reviewed with the applicant, Bibi Fatema Hashimi

NAME OF LICENSING PROGRAM MANAGER: Renesha Askew
NAME OF LICENSING PROGRAM ANALYST: Jody Dye
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 10/31/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/31/2025
LIC809 (FAS) - (06/04)
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