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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414004300
Report Date: 12/12/2025
Date Signed: 12/12/2025 11:50:30 AM

Document Has Been Signed on 12/12/2025 11:50 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 BRUNO CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME:ABDULLAH, SAIMA B.FACILITY NUMBER:
414004300
ADMINISTRATOR/
DIRECTOR:		ABDULLAH, SAIMA B.FACILITY TYPE:
810
ADDRESS:TELEPHONE:
(650) 267-0065
CITY:SOUTH SAN FRANCISCOSTATE: CAZIP CODE:
94080
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 9DATE:
12/12/2025
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:44 AM
MET WITH:Licesnee, Saima AbdullahTIME VISIT/
INSPECTION COMPLETED:
12:05 PM
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On December 12th, 2025, at 8:45AM, Licensing Program Analyst (LPA) Alvarado arrived at the facility to conduct an unannounced case management for a room addition. LPA Alvarado met with the licensee Saima Abdullah(L1). (L1) wanted to add the Dining Room and living room that was off limits and currently only approved for nap use. Purpose of the inspection was explained. After 9:00AM four more children also arrived to the facility. Present is (L1) and assistant supervising 9 children (2 Infants and 7 Preschoolers). (L1) was reminded that if no assistant provider is present at a Large Family Child Care Home, then the licensee shall comply with the capacity requirements for a Small Family Child Care Home as specified in 102416.5 Staffing Ratio and Capacity. All adults present in the home have fingerprint clearance and are associated to the facility as of today’s inspection.

LPA along with (L1) inspected the home indoors and outdoors for any health or safety hazards along with (L1). Licensee would like to add the Dining Room and living room in the lower level of the home which is a large space, living room was approved only for nap use and (L1) wants to open it for additional Family Child Care use. (L1) plan is to utilize the Dining Room and living room space for additional learning, play, arts and crafts. LPA inspected the Living room and observed it to be appropriate for Family child care home use. LPA only suggested with (L1) to place additional cushion to sharp edges such as the corners of tables to prevent any injuries. (L1) stated the facility will plan to move around furniture to better accommodate for Family Child Crae home use. Facility received fire clearance that was issued on 12/9/2025.

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NAME OF LICENSING PROGRAM MANAGER: Ali Zebila
NAME OF LICENSING PROGRAM ANALYST: Diana Alvarado
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 12/12/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/12/2025
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 BRUNO CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: ABDULLAH, SAIMA B.
FACILITY NUMBER: 414004300
VISIT DATE: 12/12/2025
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The following areas are used for Family Child Care: Part of the lower level of the Home, which includes the Bedroom, Bathroom, Family Room, and Kitchen. Outdoor Play Yard.

The Off-Limit Areas are: The entire second floor, Living Room (Only for Napping), Garage and Front Yard.

LPA observed that off limit areas were properly barricaded and made inaccessible to the children in care. Facility has stairs that lead to the second floor and (L1) placed a baby gate at the bottom of the stairs that barricade the stairs making them inaccessible to children in care. (L1) was reminded that the stairs leading to the second floor must be barricaded at all times. LPA observed age-appropriate toys and learning materials to be present. Furniture is age-appropriate and free of rough and loose parts.

Newly approved Family Child Care Home
Day Care Areas: Entire 1st Floor that consist of Bedroom, Family Room, Kitchen, Dining Room and Living Room.
Off Limits: Entire 2nd Floor, Garage and Front Yard.

As of today, 12/12/2025 Dining Room and Living Room in the lower level of the home is added as part of the day care area. Making the Entire First Floor Family Child Crae Home.

No deficiencies were cited today on 12/12/2025 under CCR, Title 22, Div. 12, Chapt. 1.

Appeal Rights were provided to (L1). A notice of site visit was provided and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the licensee, Saima Abdullah.
NAME OF LICENSING PROGRAM MANAGER: Ali Zebila
NAME OF LICENSING PROGRAM ANALYST: Diana Alvarado
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 12/12/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/12/2025
LIC809 (FAS) - (06/04)
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