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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384002816
Report Date: 03/27/2023
Date Signed: 03/27/2023 11:04:15 AM


Document Has Been Signed on 03/27/2023 11:04 AM - 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 BRUNO CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066



FACILITY NAME:KOZHINA, INNAFACILITY NUMBER:
384002816
ADMINISTRATOR:KOZHINA, INNAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(415) 335-2319
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94121
CAPACITY:14CENSUS: 11DATE:
03/27/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:10 AM
MET WITH:Inna KozhinaTIME COMPLETED:
11:35 AM
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Licensing Program Analyst (LPA) Mok conducted an unannounced annual inspection today. LPA met with the licensee, Inna Kozhina, and 2 helpers. All adults had fingerprint clearance. LPA explained the purpose of the inspection to her. 11 children including infants and 2 school-age presented with 2 helpers. The licensee had a birthday celebration set up for a child during the inspection. The facility was called "Magic Child Day Care". The facility's operation hours were Monday to Friday from 7:30 AM to 5:30 PM. The main entrance of the daycare was next to the garage door. Licensee owned this 2 stories single-family house. Licensee lived in the house by herself. There were two bedrooms, 1 bath, a living room, dining/Kitchen area on the upper level; the lower level has two bedrooms, one bath, a living room, a garage, and a backyard. The daycare areas were the entire lower level that includes 2 bedrooms, 1 bathroom, a living room, and a backyard. The off-limit areas were the entire upper level and a garage. LPA toured and inspected the facility for health and safety hazards. The facility was clean and in order. The temperature and lighting were adequate. All toxins and harmful objects were either locked or made inaccessible to the children. The facility had the right amount of cubbies were available for the children to store their belonging by the main entrance. There were plenty of age-appropriate toys, books, learning material/equipment, and children's furniture that were in good condition and repaired and available for children indoors, All the equipment and furniture were in good condition. There was a fully charged 2A10BC fire extinguisher, working smoke, and carbon monoxide detectors, a touchless thermometer, and first aid supplies available in the daycare. All electrical outlets were covered. All the lower drawers and cabinets were either latched or free of harmful in them. Carpets were used as soft cushioning on the daycare floor to prevent injury. Cots and play yard were used for napping. The children's bathroom was clean and free of harmful objects in the lower bathroom sink cabinet. The outdoor play area was completely fenced. Turf was installed in the entire outdoor area as soft cushioning to prevent injury. There were plenty of outdoor toys, ride-on-toys, playhouses, slide structures, see-saw, and children's furniture that were in good condition and repair, and available for children outdoors. The licensee installed a gate at the stairway at the play yard. Licensee has provided breakfast, AM/PM snacks, lunch, and dinner to the daycare children. Licensee and 2 helpers had current CPR/First Aid training and Child Abuse Mandated Reporter Training certificates that will expire on 1/2025 & 3/2024. The facility has conducted the fire drill with the children monthly and logged. Per the licensee, there were no guns, no weapons, and no pets in the house. Per the licensee, there were no children on special medication All the required postings were posted. LPA reviewed the children's files and obtained a copy of the current children's roster during the inspection.

This report and notice of the site visit were provided to the licensee and must be made available to the public upon request. For a quarterly update on Licensing information, go to the CCL website: www.ccld.ca.gov. For Provider Information Notice: ccld.ca.gov/PG5098.htm.
SUPERVISOR'S NAME: Garfield LeungTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Cindy MokTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:
DATE: 03/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/27/2023
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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