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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384001664
Report Date: 01/13/2022
Date Signed: 01/13/2022 11:48:49 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME:KAZARYAN, MARINEFACILITY NUMBER:
384001664
ADMINISTRATOR:KAZARYAN, MARINEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(415) 387-8301
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94121
CAPACITY:14CENSUS: 11DATE:
01/13/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:20 AM
MET WITH:Marine KazaryanTIME COMPLETED:
12:15 PM
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Licensing Program Analyst (LPA) Mok conducted an unannounced increased inspection today. LPA met with the licensee, Marine Kazaryan and her daugahter (helper). The purpose of the inspection was explained. There were 11 children with a helper present. The licensee owns this 2 story single family house. Licensee lives in the house with her husband, 3 children (a daughter and 2 sons), and one of her helpers. Per licensee, her daughter studies in another city, so she comes home for visit whenever she is on break. The operation hours of the facility were Monday to Friday from 8AM to 5:30PM during Pandemic. The daycare areas are the entire lower level, deck, and backyard except the garage. The off-limit areas are the entire upper level and the garage. LPA toured and inspected the facility for health and safety hazard. The facility was clean and in order. Temperature and lighting were adequate. All toxins and harmful objects were either locked or made inaccessible to the children. All the lower kitchen cabinets were either latched or free of harmful objects. All electrical outlets were covered. Child proof knobs were installed to the all the doors to prevent children access to the off-limit areas. There were plenty of the age-appropriate toys, books, learning material & equipment, and children's furniture available. The furniture were in good condition and repair. Cubbies were available for children to store their own belonging by the main entrance. There were a fully charged 2A10BC fire extinguisher, working cellular phone, working smoke and carbon monoxide detectors and first aid supplies available in the daycare areas. Carpet was installed to the daycare floor to prevent injury. The children's bathroom was clean and in order. The lower bathroom cabinet was latched. The facility provides breakfast, AM/PM snacks, lunch and dinner to the children. Cots were used for napping. The licensee provided the bedding to the daycare children. The outdoor play areas were completely fenced. A gate was installed at the stairway. Licensee uses the deck and backyard for the daycare. LPA inspected the yard and deck. There were some outdoor toys, ride-on-toys and children's furniture available for the children. Turf was installed into the yard as the soft cushioning to prevent injury, Per licensee, She has conducted the fire drill with the children monthly. The latest fire drill was conducted on 1/7/2022. Licensee had current CPR/First aid training certificate for review during the inspection. The certificate will be expired in 2/2022. The licensee has to renew it soon. Per licensee, there were no guns, no weapons and no pets at home. LPA reviewed the children's file and the certificate of Child Abuse Mandated Reporter Training for staff, and obtained a copy of the children roster from licensee during the inspection. Per licensee, there was a child on special medication. The facility had hand sanitizer, touch-less Thermometer, and disinfectant available to prevent COVID19 in the daycare area. LPA discussed with the licensee about her family members whoever is 18 years old or older and live in the same house he or she must have fingerprint clearance. LPA also informed the licensee about the same requirement is applied to any person who works as a helper in her daycare. The helper must have fingerprint clearance, complete Child Abuse Mandated Reporter Training, and have staff immunization (TB test, Pertussis, Measles, and flu shots). Otherwise, a deficiency will be issued.
To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.

This report and notice of site visit were discussed with the licensee and must be made available to the public upon request. For quarterly update on Licensing information, go to CCL website: www.ccld.ca.gov. For Provider Information Notice: ccld.ca.gov/PG5098.htm.

SUPERVISOR'S NAME: Ali ZebilaTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Cindy MokTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 01/13/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/13/2022
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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