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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376630096
Report Date: 09/12/2024
Date Signed: 09/12/2024 02:58:51 PM

Document Has Been Signed on 09/12/2024 02:58 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 CC RO, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME:ARAB, MOHAMMAD ESA FAMILY CHILD CAREFACILITY NUMBER:
376630096
ADMINISTRATOR/
DIRECTOR:		MOHAMMAD ESA ARABFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(619) 919-8088
CITY:LEMON GROVESTATE: CAZIP CODE:
91945
CAPACITY: 14TOTAL ENROLLED CHILDREN: 9CENSUS: 0DATE:
09/12/2024
TYPE OF VISIT:PrelicensingANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:00 PM
MET WITH:Mohammad ArabTIME VISIT/
INSPECTION COMPLETED:
03:15 PM
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On September 12, 2024 at 1:00 p.m. Licensing Program Analyst (LPA) Angela Nguyen conducted an announced pre-licensing inspection with applicant, Mohammad Arab for the purpose of a change of location. Helper, Adriana Gonzales was present at the inspection. The tour of the family childcare home was led by the applicant. The purpose of the inspection is to ensure that the home follows standards established in CCR, Title 22, Division 12, Chapter 3, for Family Child Care Homes. The hours of operation: Monday- Sunday 6:00 a.m.- 5:00a.m. The home is a 1 bedroom 1 bathroom single story home.
On 9/3/2024 a fire clearance was granted for a large license (14 children). The day care areas include living room, kitchen, bathroom, and backyard. The off-limit areas during childcare hours: master bedroom. It is made inaccessible to children with a lock on the doorknob. Applicant will utilize the fenced backyard for outdoor activities. LPA informed applicant to ensure children are continuously supervised during outdoor activities.
Applicant stated there are no of water on the premises. LPA observed there was no bodies of water. There is an electric heater in the home that is located in the living room. LPA observed the heater has a safety screen. The carbon monoxide detectors and smoke alarms meet requirements and are in working order. The fire extinguisher is rated 2-A:10-B-C is located in the kitchen mounted by the washer and dryer. The applicant states there are no firearms, no other weapons, or ammunition in the home. Cleaning compounds, medication and poisons are in locked under the sink inaccessible to children. Applicant has a working telephone service. Applicant does have toys, equipment, and furniture available for day care children. The designated area to isolate sick children is in on the couch in the living room.

Because the applicant rents/leases the home, proof of landlord notification is required. The applicant does not have a signed Property Owner/Landlord Consent form (LIC 9149) at this time.
On this date, 9/11/2024, 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. See 809C
SUPERVISORS NAME: Tulam Vu
LICENSING EVALUATOR NAME: Angela Nguyen
LICENSING EVALUATOR SIGNATURE: DATE: 09/12/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/12/2024
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
SAN DIEGO CC RO, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME: ARAB, MOHAMMAD ESA FAMILY CHILD CARE
FACILITY NUMBER: 376630096
VISIT DATE: 09/12/2024
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 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.”
Applicant has completed the Mandated Reporter AB1207 training certification on 8/31/2024. Applicant was advised that all helpers will need to complete this training. Applicant has completed the 8 hours of preventative health practices. Pediatric CPR and First Aid certifications expire on 9/2026. Applicant was advised all helpers will need to complete this training if left alone with children. Required documents are posted. Applicant and all adult residents in the home have all received criminal record clearances on file. Immunization records per SB were reviewed. Helper records were reviewed and determined to be complete.

Applicant has completed the Mandated Reporter AB1207 training certification on 8/31/2024. Applicant was advised that all helpers will need to complete this training. Applicant has completed the 8 hours of preventative health practices. Pediatric CPR and First Aid certifications expire on 9/2026. Applicant was advised all helpers will need to complete this training if left alone with children. Required documents are posted. Applicant and all adult residents in the home have all received criminal record clearances on file. Immunization records per SB were reviewed. Helper records were reviewed and determined to be complete.

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.

LPA advised that prior to making alterations or additions to the home or grounds, the applicant shall notify the Department of the proposed change. Applicant states they are financially secure to operate a family childcare home for children and will comply with all regulations and laws governing family childcare homes.
Licensee stated that he will purchase crib or play yard for each infant when he has infants in care. Applicant shall physically check on sleeping infants up to 24 months of age every 15 minutes. An Individual Infant Sleeping Plan [LIC 9227] shall be maintained for each infant up to 12 months of age. Licensee stated he will place infants up to 12 months of age on their backs for sleeping. See 809 C
SUPERVISORS NAME: Tulam Vu
LICENSING EVALUATOR NAME: Angela Nguyen
LICENSING EVALUATOR SIGNATURE:

DATE: 09/12/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/12/2024
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 CC RO, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME: ARAB, MOHAMMAD ESA FAMILY CHILD CARE
FACILITY NUMBER: 376630096
VISIT DATE: 09/12/2024
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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-and-resources/safe-sleep as an additional resource.

A sample of children’s records, sleep logs, children roster and emergency disaster log was reviewed with the applicant. LPA reviewed with the 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. LPA also discussed unusual incident reporting, SIDS, shaken baby syndrome, community resources and emergency disaster logs. Applicant was also informed the following items are prohibited during day care operating hours: walkers, exersaucers, jumpers and johnny bouncy seats. Corporal punishment and smoking are also not allowed in the day care.

LPA discussed Incidental Medical Services with applicant and will discuss at a later date when there are children enrolled. For IMS information, see PIN 22-02-CCP. 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.

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-and-resources/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.

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.
See 809C
SUPERVISORS NAME: Tulam Vu
LICENSING EVALUATOR NAME: Angela Nguyen
LICENSING EVALUATOR SIGNATURE:

DATE: 09/12/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/12/2024
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 CC RO, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME: ARAB, MOHAMMAD ESA FAMILY CHILD CARE
FACILITY NUMBER: 376630096
VISIT DATE: 09/12/2024
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 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.

Please visit the Guardian web page and set-up your Guardian account. https://cdss.ca.gov/inforesources/cdss-programs/community-care-licensing/caregiver-background-check/guardian. If you have any questions regarding Guardian, please contact CDSS at email: guardian@dss.ca.gov
Southern California Child Care Advocate information was provided, and applicant was encouraged to subscribe through the CCLD website to be placed on an email list for updated regulation information. Advocate information was provided: (714) 703-2800 or childcareadvocatesprogram@dss.ca.gov.

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.


The following corrections are needed prior to licensure:

• Children’s file forms shall be updated according to new facility address.

Applicant states the above corrections and photos will be provided via email to LPA by 9/19.
Once corrections have been made, a large family childcare home license may be issued upon final file review.

Exit interview conducted and report was reviewed with the applicant, Mohammad Esa Arab.
SUPERVISORS NAME: Tulam Vu
LICENSING EVALUATOR NAME: Angela Nguyen
LICENSING EVALUATOR SIGNATURE:

DATE: 09/12/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/12/2024
LIC809 (FAS) - (06/04)
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