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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376105044
Report Date: 10/07/2021
Date Signed: 10/07/2021 05:11:21 PM

Document Has Been Signed on 10/07/2021 05:11 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:MEDINA LEARNING CENTER LLCFACILITY NUMBER:
376105044
ADMINISTRATOR:SHARIFA OSMANFACILITY TYPE:
840
ADDRESS:6066 1/2 UNIVERSITY AVENUETELEPHONE:
(619) 906-4177
CITY:SAN DIEGOSTATE: CAZIP CODE:
92115
CAPACITY: 15TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
10/07/2021
TYPE OF VISIT:OfficeANNOUNCEDTIME BEGAN:
03:30 PM
MET WITH:Anab Hade, Rahmo Abdi and Naima DhagahTIME COMPLETED:
05:15 PM
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On 10/07/2021 at 03:30 PM, Licensing Program Analysts (LPA) Selina Siao met with Anab Hade (applicant), Rahmo Abdi (Somali translator from Somoli Youth United that is assisting applicant with her pending application) and Naima Dhagah (applicant's relative) in the San Diego Child Care Regional Office. The purpose of today's meeting is to review the most recent LIC184D dated 08/16/2021 together and to clarify anything that Applicant and representatives had questions on due to the incomplete documents that was submitted to the department on 08/31/2021.

On 09/23/2021, LPA Siao emailed the notice of incomplete application with the missing documents that was either missing or incomplete documents to Rahmo Abdi.

The following documents are needed to complete the pending application packet, the documents will be submitted to Licensing within 7 days by 10/17/2021:

Verification of Director Sharifa Osman including immunization for Tdap.

Employee Handbook- Trainings for staff (pg. 8) should include all six items listed on 101216(e), report of child abuse pg.10 should include the listed numbers is the child abuse hotline and the reporting requirements to licensing.

Needs to list hiring practices on the employee handbook.
SUPERVISORS NAME: Monica Cuddy
LICENSING EVALUATOR NAME: Selina Siao
LICENSING EVALUATOR SIGNATURE: DATE: 10/07/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/07/2021
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
CCLD Regional Office, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME: MEDINA LEARNING CENTER LLC
FACILITY NUMBER: 376105044
VISIT DATE: 10/07/2021
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Parent Handbook- Missing cover page, Days and hours of operation doesn’t match the application, Page. 3 Enrollment for the Children is missing the following forms: Consent for emergency medical treatment (LIC627) and Child’s Pre-admission Health History-Parents Report (LIC702), Page. 4 under Schedule Information for the Preschool shows 7am-11pm, Page .12 under Emergency Plans indicates that in case of a real fire the children will be taken to the closet school which is different than the information on the LIC610 Emergency Disaster plan. (both information should match), Page. 13 Please provide example and clarification of what it means. “If for any reason you fail to comply and Medina Learning Center is assessed a civil penalty, you will be responsible to pay all fees associated with your lack of compliance.”, Missing refund policy information, Missing discipline policies information types of discipline, types of discipline not permitted, provisions for contacts/conferences with parents included and grounds for dismissal.

Schedule of daily activities for the children's activities and should match the operating hours when children are in care on LIC200A.

List of Furniture and Play Equipment- Please indicate the list of furniture including tables, chairs, cots or mats, toys and equipment that have or will be purchased for the school age program, please include the quantity of the item.

LPA provided applicant and facility representatives with the regulation on 101216 Personnel Requirement, Child abuse hotline information and California hiring policy.
Also provided applicant and representative to department's regulation links to child care center.https://cdss.ca.gov/inforesources/child-care-licensing/resources-for-providers/laws-and-regulations
SUPERVISORS NAME: Monica Cuddy
LICENSING EVALUATOR NAME: Selina Siao
LICENSING EVALUATOR SIGNATURE:

DATE: 10/07/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/07/2021
LIC809 (FAS) - (06/04)
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