Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376624822
Report Date: 07/11/2017
Date Signed 07/11/2017 02:50:42 PM

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:BULHAN, YURUB FAMILY CHILD CAREFACILITY NUMBER:
376624822
ADMINISTRATOR:YURUB BULHANFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(619) 436-8821
CITY:SAN DIEGOSTATE: CAZIP CODE:
92105
CAPACITY:14CENSUS: 0DATE:
07/11/2017
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME BEGAN:
02:05 PM
MET WITH:Yurub BulhanTIME COMPLETED:
03:00 PM
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LPA, Luigi Gargaro, conducted an unannounced inspection with the licensee. The home was toured and inspected to ensure an environment safe for the care and supervision of children per the standards established in CCR, Title 22, Division 12, Chapter 3, for Family Child Care Homes. Present were the licensee and no day care children. The fire extinguisher and smoke and carbon monoxide detectors meet requirements and are operational. All hazardous items were latched/locked and secured out of reach of children. There are no bodies of water or weapons in the home. A review of staff records on this date indicates that all adults or other individuals who require caregiver background checks have received criminal record and child abuse clearances or exemptions. First Aid and CPR certifications expire on 10/08/18. Children’s records were reviewed.

Licensee has provided adequate space for the children to eat, sleep and play within the home. Areas used for child care include: the kitchen, the dining area, the living room and the day care bathroom. Off limits areas include the entire second floor which is made inaccessible through use of a child safety gate installed at the bottom of the staircase landing. The licensee has sufficient toys and equipment available. The home has a fenced front patio available for outdoor activities. As the patio only has an open doorway with no latching gate to secure it, the licensee was reminded that direct supervision should be used whenever children are playing in it. It was inquired of licensee as to whether she currently has any children who require any type of Incidental Medical Services and she responded that she is not caring for any children who require IMS at this time. The licensee states that she understands, however, that she must document and submit a plan of operation to licensing on how she will be caring for children who need IMS whenever she enrolls them in her program.

Licensee's home appeared to be in compliance today and no violations were cited. Analyst printed a copy of the Notice Of Site Visit today and had licensee place it in her facility notice area before he left the home.
SUPERVISOR'S NAME: Carl SheltonTELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: Luigi GargaroTELEPHONE: (619) 767-2229
LICENSING EVALUATOR SIGNATURE:

DATE: 07/11/2017
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/11/2017
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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