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Home › CA › San Diego › Khalif, Samsam Family Child Care
San Diego CA 92119 · License #376100575 · Home-based · Family Day Care Home
Not published by the state. Owners can add hours via profile claim.
When they operate
Ages served
102370(d)(1) · 102370(d)(1) CRIMINAL RECORD CLEARANCE: All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1596.871 shall prior to working, residing, or volunteering in a licensed facility: (1) Obtain a California clearance or a criminal record exemption as required by the Department.
The licensee, Ms. Khalif, stated that in the future, she will ensure that all adults residing, working or having a prominent presence will be fingerprint cleared and associated before their first date in the home or within 30 days of their 18th birthday if living in the home. Based on record review and interview with the licensee, the licensee's former helper, Vera Stone, did not have a fingerprint clearance or criminal record exemption on file. Further, Ms. Khalif confirmed that she will provide a written statement to the department that she understands and wil abide by all requirements related to criminal record clearances and check with CPMB/Guardian. Email: Gerald.Poindexter@dss.ca.gov Joelle Redding NAME OF LICENSING PROGRAM MANAGER: Gerald Poindexter NAME OF LICENSING PROGRAM ANALYST: LICENSING PROGRAM ANALYST SIGNATURE: DATE: 07/01/2025 I acknowledge receipt of this form and understand my appeal rights as explained and received.
Open Not marked corrected in the state record
Category: background checks. Open / not marked corrected.
Disposition: Substantiated
Disposition: Unsubstantiated
Disposition: Unsubstantiated
Disposition: Substantiated
Disposition: Substantiated
Generated from this facility's specific inspection record
Data synced from California DSS, Community Care Licensing Division on Jul 8, 2026 · Source records · Report an error
102416.1(d) · PERSONNEL RECORDS: (d) All personnel records shall be maintained at the child care home and shall be available to the licensing agency for review.
Licensee stated that she will create files for both helpers and send proof to the LPA by the POC due date. LPA provided document listing Helper Requirements. Email: Gerald.Poindexter@dss.ca.gov Based on record review and interview, the licensee had background clearances for, but not personnel files for helpers Vera Stone and Kos Osborne, which poses a potential health, safety or personal rights risk to persons in care.
Open Not marked corrected in the state record
Category: background checks. Open / not marked corrected.
102419(d) · Admission Procedures and Parental and Authorized Representative's Rights: (d) At the time of acceptance of each child into care, the licensee shall provide the child's parent or authorized representative with a copy of the notice Family Child Care Home Notification of Parent's Rights, LIC 995A (8/06), the Caregiver Background Check Process, LIC 995E (6/05), and the Family child Care Consumer Awareness Information, LIC 9212 (10/05).
Licensee stated that she will have parents provide complete paperwork. Licensee will submit proof by the POC due date. LPA provided LIC311D for review. Email: Gerald.Poindexter@dss.ca.gov Based on record review, Licensee was missing entire childrens files or had incomplete files for children in care which poses a potential Health, Safety, or Personal Rights risk to children in care. Joelle Redding NAME OF LICENSING PROGRAM MANAGER: Gerald Poindexter NAME OF LICENSING PROGRAM ANALYST: LICENSING PROGRAM ANALYST SIGNATURE: DATE: 05/08/2025 I acknowledge receipt of this form and understand my appeal rights as explained and received.
Open Not marked corrected in the state record
Category: health medication. Open / not marked corrected.
102418(g) · IMMUNIZATIONS: The licensee shall document each Child's immunization as required by the California code of regulations, title 17, section 6070, and shall maintain such documentation for as long as the child is enrolled.
… Licensee stated that she will have parents provide immunizations for all children in care and understands that she will make sure that all forms are properly filled out and send proof to the LPA by the POC due date. Email: Gerald.Poindexter@dss.ca.gov Based on interview and record review, Licensee did not comply with the regulation above, she did not have immunizations for children in care. This poses a potential Health, Safety, or Personal Rights risk to children in care.
Open Not marked corrected in the state record
Category: health medication. Open / not marked corrected.
102416.2(b)(3)(c) · 102416.2(b)(3)(c) "A report shall be made to the Department…following the occurrence during the operation of a family day care home of any of the following events:(C) Any unusual incident or child absence that threatens the physical or emotional health or safety of any child."
LPA printed the reporting requirements regulation for the licensee, who stated she will ensure that any future incidents are reported to the duty line 619-767-2248 within 24 hours by phone and submitted within 7 days of the incident occurring via Unusual Incident Report by email to Based on record review and information gathered during another matter, the facility did not report to the Department an unusual incident on 4/25/25 to a daycare child, which poses a potential health, safety or personal rights risk to persons in care. SDIncidentReports@dss.ca.gov or by Fax at619-767-2203. Ms. Khalifa will also provide written statement to LPA at Gerald.Poindexter@dss.ca.gov by 5/22/25 explaining that she will submit future reports per the required time frames. Joelle Redding NAME OF LICENSING PROGRAM MANAGER: Gerald Poindexter NAME OF LICENSING PROGRAM ANALYST: LICENSING PROGRAM ANALYST SIGNATURE: DATE: 05/08/2025 I acknowledge receipt of this form and understand my appeal rights as explained and received.
Open Not marked corrected in the state record
Category: ratio. Open / not marked corrected.
102417(g)(8) · Children’s Roster: (8) Each family child care home shall have a current roster of children as specified in Health and Safety Code Section 1596.841.
Licensee states she will create and submit a complete roster of enrolled children and submit a copy to the Department by 5/22/25. Email: Gerald.Poindexter@dss.ca.gov Based on record review, the licensee did not comply with the section cited above, as the current roster of children was incomplete, which poses a potential health, safety or personal rights risk to persons in care.
Open Not marked corrected in the state record
Category: health medication. Open / not marked corrected.
102417(g) · Operation of A Family Child Care Home: (g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to...
Licensee removed the room divider and stated that she will install a gate or other more secure barrier. The licensee will send LPA a photo by POC due date. Email: Gerald.Poindexter@dss.ca.gov LPA observed a crawling infant make contact with and partially dislodge a 4-panel room divider, which poses/posed a potential health, safety or personal rights risk to persons in care. Joelle Redding NAME OF LICENSING PROGRAM MANAGER: Gerald Poindexter NAME OF LICENSING PROGRAM ANALYST: LICENSING PROGRAM ANALYST SIGNATURE: DATE: 05/08/2025 I acknowledge receipt of this form and understand my appeal rights as explained and received.
Open Not marked corrected in the state record
Category: ratio. Open / not marked corrected.
102421(a) · Child's Records (a) The licensee shall maintain, in each child's record, the signed and dated notice form required in Section 102419(d).
Deficient Practice Statement Based on observation, interview and record review, the licensee did not comply with the section cited above in 4 out of 5 children records, which poses a potential health, safety or personal rights risk to persons in care. POC Due Date: 01/30/2025
Open Not marked corrected in the state record
Category: health medication. Open / not marked corrected.
102425(j)(2)(D)(c) · Infant Safe Sleep Documentation shall be maintained in the infant’s file and be available to the Department for review. Documentation shall include the following: Time of each 15-minute check
Deficient Practice Statement Based on observation and record review, the licensee did not comply with the section cited above in 2 out of 5 children records, which poses/posed a potential health, safety or personal rights risk to persons in care. POC Due Date: 01/30/2025
Open Not marked corrected in the state record
Category: health medication. Open / not marked corrected.
102417(a) · 102417(a)-Operation of a Family Child Care Home: The licensee shall be present in the home and shall ensure that children in care are supervised at all times... Temporary absences shall not exceed 20 percent of the hours that the facility is providing care per day.
For upcoming trip planned Licensee will go inactive for the duration of the trip and inform parents to make altrnative arrangements. LPA provided LIC 9211- Request for Inactive form to be completed prior to trip. Licensee stated she will discuss with parents to determine dates for inactive. Based on observation, interviews, and documentation reviewed licensee has exceeded the time allowed for absences. Licensee has taken several trips and has not been at the home when licensing has made unannounced visits on multiple occasions. This poses a potential health, safety, and personal rights risk to children in care.
Open Not marked corrected in the state record
Category: supervision. Open / not marked corrected.
102416.5(a) · 102416.5(a) Staffing Ratio and Capacity: The capacity specified on the license shall be the maximum number of children for whom care may be provided at any one time. The
Provider has began keeping attendance sheets in the home and maintains schedule for each child nearby. Provider will ensure no more than licensed capacity of 14 children are cared for at one time and will mark time on attendance sheets rather that have parents do it. Provider will email
Open Not marked corrected in the state record
Category: ratio. Open / not marked corrected.
102417(g)(7) · Operation of A Family Child Care Home (7) An emergency information card shall be maintained for each child and shall include the child's full name, telephone number and location of a parent or other responsible adult to be contacted in an emergency, the name and telephone number of the child's physician and the parent's authorization for the licensee or registrant to consent to emergency medical care.
Deficient Practice Statement Based on record review, the licensee did not comply with the section cited above in 3 out of 4 files reviewed which poses/posed a potential health, safety or personal rights risk to persons in care. POC Due Date: 11/26/2021
Open Not marked corrected in the state record
Category: ratio. Open / not marked corrected.