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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434414274
Report Date: 06/28/2024
Date Signed: 06/28/2024 12:59:23 PM

Document Has Been Signed on 06/28/2024 12:59 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 JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME:HALLAB, FATIMAFACILITY NUMBER:
434414274
ADMINISTRATOR/
DIRECTOR:		HALLAB, FATIMAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(408) 477-9350
CITY:SANTA CLARASTATE: CAZIP CODE:
95050
CAPACITY: 14TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
06/28/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:49 AM
MET WITH:Fatima HallabTIME VISIT/
INSPECTION COMPLETED:
01:15 PM
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Licensing Program Analyst (LPA) Mandeep Kaur conducted an unannounced Annual/Random inspection. LPA met with Licensee, Fatima Hallab and explained the reason for the inspection. Present during today's inspection were Licensee and her husband.

The hours of operation are Monday through Friday 7:30AM- 03:00PM. There is an area to post required postings, such as license and notification of parent's rights.

LPA toured the inside and outside of the home with Licensee. Day care areas are on the ground floor, which include the two rooms, the living room, the bedroom, the bathroom, and the backyard. Off limit areas are the garage and the entire second floor and kitchen. Disinfectant and cleaning supplies were inaccessible to children. LPA reminded Licensee that anything sharp or states to keep out of reach of children, such as blades or razors need to be inaccessible.

Licensee stated that she does not have any children enrolled at this time. Licensee stated that she might go inactive or surrender the license.

There is a fully charged fire extinguisher, smoke detector, and carbon monoxide detector. Licensee stated that there are no weapons, such as firearm, stored in the home.


-----------------CONTINUES ON 809 DATED 04/15/2024 PAGE 2-----------------
SUPERVISORS NAME: Belinda Devall
LICENSING EVALUATOR NAME: Mandeep Kaur
LICENSING EVALUATOR SIGNATURE: DATE: 06/28/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/28/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: HALLAB, FATIMA
FACILITY NUMBER: 434414274
VISIT DATE: 06/28/2024
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--------------CONTINUATION OF 809 DATED 04/15/2024 PAGE 1-------------

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

Licensee was informed of the MyChildCarePlan.org website; 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.

Licensee completed the Mandated Reporter training on 06/2025. Licensee has a valid CPR/1st Aid.

----------------CONTINUES ON 809 DATED 04/15/2024 PAGE 3----------------
SUPERVISORS NAME: Belinda Devall
LICENSING EVALUATOR NAME: Mandeep Kaur
LICENSING EVALUATOR SIGNATURE:

DATE: 06/28/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/28/2024
LIC809 (FAS) - (06/04)
Page: 2 of 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: HALLAB, FATIMA
FACILITY NUMBER: 434414274
VISIT DATE: 06/28/2024
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--------------CONTINUATION OF 809 DATED 04/15/2024 PAGE 2-------------

The adults 18 and over living in the home are Licensee and her two adult children. All adults have cleared
criminal record and child abuse index. Licensee 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.

During the exit interview, the Licensee, Fatima Hallab, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

As a result of this inspection, No citation was issued.

Exit interview conducted and report was reviewed with Licensee, Fatima Hallab. A notice of site visit has been issued and must remain posted for 30 days.
SUPERVISORS NAME: Belinda Devall
LICENSING EVALUATOR NAME: Mandeep Kaur
LICENSING EVALUATOR SIGNATURE:

DATE: 06/28/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/28/2024
LIC809 (FAS) - (06/04)
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