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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376101096
Report Date: 05/31/2023
Date Signed: 05/31/2023 02:01:28 PM

Document Has Been Signed on 05/31/2023 02:01 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 NORTH, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME:HAOUASH, KHETAM FAMILY CHILD CAREFACILITY NUMBER:
376101096
ADMINISTRATOR:KHETAM HAOUASHFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(901) 254-4526
CITY:EL CAJONSTATE: CAZIP CODE:
92020
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: DATE:
05/31/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:20 PM
MET WITH:Licensee, Khetam HaouashTIME COMPLETED:
02:15 PM
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Licensing Program Analyst (LPA), Saraliz Velando, conducted an announced Prelicensing Inspection. LPA was greeted at the front door by licensee, Khetam Haouash. LPA was granted entry after identifying herself and disclosing the purpose of her visit. The applicant has applied for a capacity of eight (8). The 2 story apartment home consists of two bedroom and two bathroom. The applicant will be using the following areas for daycare: Living room, Dining room, Bathroom 1, Kitchen, and Patio. Off limit areas include: All upstairs bedroom 1 and 2, and Bathroom 2 and has been made inaccessible by baby safety gate. Outdoor play also takes place at a nearby park with constant supervision. Business Hours are Monday- Sunday, 7:00am-11:00am and 2:00pm-4:00pm. An overall inspection of the home was conducted. The inspection included, but was not limited to:

The home has a functioning smoke alarm in bedroom 1 and a carbon monoxide detector in the dining room area. There is a fire extinguisher in the kitchen area that meets regulations. There is no fireplace or wall heaters in the home. Storage areas for poisons, detergents, cleaning solutions, medications, and items which state keep out of reach of children have been placed in Off Limit rooms, placed out of reach, and safety latched and made inaccessible to children. There is a community pool that meets regulations and is only accessible by a tenant key and gate remains closed and locked at all times. There is no garage attached to the unit. Applicant stated there are no weapons or ammunition stored on the premises and LPA did not observe any. The home is kept clean with heating and ventilation for safety and comfort. The home provides safe toys, play equipment and materials. Licensee's last fire drill was conducted on 4/11/23. The applicant has completed training on preventive health practices including pediatric CPR/First Aid which expires December 2024. The applicant speaks mostly Arabic and is exempt from Mandated Reporter Training. There is a working telephone and email address.
SUPERVISORS NAME: Monica Cuddy
LICENSING EVALUATOR NAME: Saraliz Velando
LICENSING EVALUATOR SIGNATURE: DATE: 05/31/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/31/2023
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 NORTH, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME: HAOUASH, KHETAM FAMILY CHILD CARE
FACILITY NUMBER: 376101096
VISIT DATE: 05/31/2023
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LPA reviewed with 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.
The new provider packet was reviewed with the applicant including information on immunizations, child abuse reporting, car seat laws, shaken baby syndrome, SIDS, and the effects of lead poisoning. Applicant was also reminded that corporal punishment, smoking, walkers, exersaucers, jumpers and bouncy seats shall not be permitted during daycare operation. All equipment that is used should be used only as intended by the manufacturer. Applicant states they are aware that interference with a child’s daily functions, physical or mental abuse and corporal punishment is not permitted. LPA and applicant discussed California Megan’s Law and LPA provided the link www.meganslaw.ca.gov.

LPA discussed 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 CPSC to be notified of any recalls on their purchased equipment.

LPA discussed the following with the applicant: Maximum capacity for a small family child care home; 4 infants only (infants defined as children under 24 months) or 6 children with no more than 3 infants; or with landlord consent, 8 children with no more than 2 infants – 1 child in kindergarten or elementary school and 1 child at least age 6 including children under the age of 10 who reside in the applicant’s home.

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, 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 up to $500 maximum per day/per person will be assessed if there is regulation is violated.
SUPERVISORS NAME: Monica Cuddy
LICENSING EVALUATOR NAME: Saraliz Velando
LICENSING EVALUATOR SIGNATURE:

DATE: 05/31/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/31/2023
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 NORTH, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME: HAOUASH, KHETAM FAMILY CHILD CARE
FACILITY NUMBER: 376101096
VISIT DATE: 05/31/2023
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LPA provided the applicant with the following: Child Care Advocates email address of [email protected].

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: http://www.ada.gov/childqanda.htm

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platform. 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.

There were no deficiencies cited today. Applicant agrees to comply with all regulations and laws governing Large Family Child Care Homes.

Exit interview was conducted and report was reviewed with licensee, Khetam Haouash.
SUPERVISORS NAME: Monica Cuddy
LICENSING EVALUATOR NAME: Saraliz Velando
LICENSING EVALUATOR SIGNATURE:

DATE: 05/31/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/31/2023
LIC809 (FAS) - (06/04)
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