376103109-3-5-2026-51-CC-GPOR-DRVQE5-20260305110547

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 376103109
Report Date: 03/05/2026
Date Signed: 03/05/2026 11:06:04 AM

Document Has Been Signed on 03/05/2026 11:06 AM - 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:	AHMADI, MOZLIFA FAMILY CHILD CARE		FACILITY NUMBER:	376103109
ADMINISTRATOR/ DIRECTOR:	MOZLIFA AHMADI		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(619) 577-9052
CITY:	EL CAJON	STATE: CA	ZIP CODE:	92019
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 0	CENSUS: 0	DATE:	03/05/2026
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	09:00 AM
MET WITH:	Mozlifa Ahmadi		TIME VISIT/ INSPECTION COMPLETED:	11:30 AM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	On 3/5/26 at 9:00 am, Licensing Program Analyst (LPA) Gerald Poindexter identified himself and disclosed the nature of the visit before being granted entry. LPA Poindexter then conducted an announced pre-licensing inspection with capacity increase. LPA met with applicant Mozlifa Ahmadi. Also, present: the applicant’s husband Dawood Ahmadi (who provided translation; applicant’s preferred language is Pashto) and three of there minor children. The 3-bedroom, 2.5-bath, 2-story home was toured and inspected to ensure an environment safe for the care and supervision of children. Applicant rents the home. Verification of control of property is on file. Property owner/landlord notification is on file. The applicant has obtained a signed Property Owner/Landlord Consent form (LIC9149). Applicant states that they have sufficient financial resources to sustain the license. Fire clearance was granted on 2/8/26 and subsequently provided to the Licensing Department. Applicant will use the following rooms for childcare: Living Room areas 1 and 2 (identified as “hall” on the facility sketch), downstairs bathroom, kitchen, and backyard. One of the living room areas will be used to care for/separate sick children. Off-limits areas include: the entire second floor, garage, and front yard. These areas prevent access through use of a safety gates, latches and door locks, and door locks (front yard). Stairs to the second floor are inaccessible through the use of a safety gate. The garage is off limits and is kept inaccessible using a door lock and latches. Applicant has a fully fenced backyard available for outdoor activities. No hazardous items were observed in the backyard. Applicant stated that she understands that direct, continuous visual supervision is required at all times when outside. There are no bodies of water in the home. CONTINUED ON PAGE 2

NAME OF LICENSING PROGRAM MANAGER: Joelle Redding
NAME OF LICENSING PROGRAM ANALYST: Gerald Poindexter
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 03/05/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/05/2026

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: AHMADI, MOZLIFA FAMILY CHILD CARE	FACILITY NUMBER: 376103109
	VISIT DATE: 03/05/2026

NARRATIVE

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There is a working phone at the facility. The fire extinguisher meets 2A10BC requirements. Carbon monoxide detector and smoke detector were tested and are operational. Poisons, cleaning compounds, medications and other hazardous items were latched/locked and secured out of reach of children. Heating and ventilation equipment were reviewed. Downstairs fireplace is screened and latched. Applicant states there are NO firearms and weapons in the home. The applicant has age-appropriate toys and equipment available.

Pediatric CPR and First Aid expire 12/3/27. Preventative health practices course (with lead poison prevention training) completed. Applicant is exempt from Mandated Reporter AB1207 training certification due to having limited English proficiency. Applicant’s primary language is Pashto. Resident immunization requirements were met. All required facility-related documents were visibly posted. Large license capacity graphic was provided and reviewed with the applicant. Helper requirements were reviewed. Applicant states that they will use their 15-year-old child as a volunteer, as needed. LPA reminded the applicant that they must be present at all times in the home to supervise daycare children and a volunteer under 18 years old.

The applicant 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 reviewed the following resources and information with applicant:
· LIC 311D, Forms/Records to Keep in Your Family Child Care Home, children’s forms/records, facility forms/records, and information required to be posted
· New provider packet, including unusual incident reporting procedures
· Rules related to children’s personal rights, child abuse, and prohibiting of corporal punishment
· Rules prohibiting smoking, walkers, exersaucers, jumpers and bouncy seats. Also, allowed/prohibited uses of car seats.
CONTINUED ON PAGE 3

NAME OF LICENSING PROGRAM MANAGER: Joelle Redding
NAME OF LICENSING PROGRAM ANALYST: Gerald Poindexter
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 03/05/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/05/2026

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: AHMADI, MOZLIFA FAMILY CHILD CARE	FACILITY NUMBER: 376103109
	VISIT DATE: 03/05/2026

NARRATIVE

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·Use of all equipment only as intended by the manufacturer
· Shaken Baby Syndrome and SIDS
· California Megan's Law and website: www.meganslaw.ca.gov
· COVID-19 and other communicable diseases guidelines and resources
· Provider Information Notices (PINs), Program Quarterly Update Newsletters, and the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe.
· YMCA Resource Center information
· Additional CDSS contact information and provider resources

LPA discussed the 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 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, 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) or (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-care-centers

No corrections are needed. A license for 14 children may be granted upon final file review. Applicant agreed to comply with all regulations and laws governing family child-care homes. Exit interview conducted and report was reviewed with the applicant, Mozlifa Ahmadi. Appeal rights provided.

NAME OF LICENSING PROGRAM MANAGER: Joelle Redding
NAME OF LICENSING PROGRAM ANALYST: Gerald Poindexter
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 03/05/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/05/2026

LIC809 (FAS) - (06/04)

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