414001707-4-12-2023-05-CC-CQUO-CQTVLU-20230412163227

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 414001707
Report Date: 04/12/2023
Date Signed: 04/12/2023 04:32:36 PM

Document Has Been Signed on 04/12/2023 04:32 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 BRUNO CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME:	KARAPETYAN, ZHANNETA S.		FACILITY NUMBER:	414001707
ADMINISTRATOR:	KARAPETYAN, ZHANNETA S.		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(650) 758-1518
CITY:	DALY CITY	STATE: CA	ZIP CODE:	94015
CAPACITY:	14	CENSUS: 10	DATE:	04/12/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	08:35 AM
MET WITH:	Zhanneta Karapetyan		TIME COMPLETED:	11:00 AM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	On April 12, 2023 at approximately 8:35am, Licensing Program Analyst (LPA) Catrina Quimbo conducted an unannounced, annual inspection. LPA met with licensee, Zhanneta "Janet" Karapetyan, and explained the purpose of the inspection. Present during LPA's visit included licensee, licensee's teaching assistant, and 10 enrolled children (1 infant and 9 preschool age children). Licensee is operating within capacity limits and ratio during LPA's visit. All adults living and/or working in the home have fingerprint clearance on file. Hours of operation are Monday to Friday 7:30am to 5:30pm. Licensee operates home as a Montessori program. The DAY CARE AREAS are the living room, dining area, hallway bathroom, and backyard. The OFF LIMIT AREAS are the garage, office room (next to garage), kitchen, and all bedrooms on upper level. With licensee, LPA conducted a health and safety inspection of the day care areas. LPA observed home to be in good repair with proper temperature and ventilation. Home is equipped with a variety of age appropriate toys and materials that were in good condition. LPA observed home to have a variety of Montessori materials that were age appropriate. Main day care area includes a fireplace that was made inaccessible to children and appropriately barricaded. Edges on fireplace and sharp edges in home were appropriately covered for additional safety. LPA observed cleaning supplies, poisons and other chemicals to be inaccessible in home's high shelves and not located in day care areas. Bathroom for children's use was observed to be clean and in proper working condition. The bathroom was equipped with children's individual hand towels and appropriate sanitation products. LPA did not observe any poisons, chemicals or hazardous materials in accessible drawers located in bathroom. Home is equipped with a fully stocked first aid kit, fully charged fire extinguisher, and multiple working smoke/carbon monoxide detectors. Per licensee, there are no weapons or firearms in the home. (Continue Report on Page 2...)

SUPERVISOR'S NAME: Garfield Leung	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Catrina Quimbo	TELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 04/12/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/12/2023

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 BRUNO CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: KARAPETYAN, ZHANNETA S.	FACILITY NUMBER: 414001707
	VISIT DATE: 04/12/2023

NARRATIVE

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Entire outdoor area is enclosed with an at least 5 ft. high fence. LPA observed outdoor area to be equipped with outdoor toys and materials that were observed to be in proper working condition. Outdoor area includes an additional shed that is included as a day care area for children. Flooring in outdoor area includes cushioning with both artificial turf and grass. LPA did not observe any pools, spas or bodies of water on site.

LPA observed licensing documentation to be properly posted and available for review in home. Licensee maintains a child care roster. LPA reviewed five random children's records, that were complete. Children's files have a record of emergency identification information on file.

Licensee's CPR is current and will expire 08/2024. Licensee's Mandated Reporter certification is also current and will expire 05/2024. Licensee's required immunizations were made available for review. Emergency drills are conducted at least once every six months and are properly documented. Last disaster drill was conducted 01/25/2023.

Licensee was reminded, as of September 1, 2016, all Staff and Volunteers must provide proof of immunization against pertussis, measles, and influenza, or qualifies for an exemption, pursuant to Health and Safety code 1596.7995 and 1597.622.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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

Licensee was reminded that all adults 18 and over living or working in the home, 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 $500.00 maximum per day/per person will be assessed if this regulation is violated.
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SUPERVISOR'S NAME: Garfield Leung	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Catrina Quimbo	TELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 04/12/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/12/2023

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 BRUNO CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: KARAPETYAN, ZHANNETA S.	FACILITY NUMBER: 414001707
	VISIT DATE: 04/12/2023

NARRATIVE

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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.

LPA discussed the safe sleep regulations with licensee 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 licensee 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 the CPSC to be notified of any recalls on their purchased equipment.

No deficiencies were cited today under CCR, Title 22, Div. 12.

A notice of site visit was given and must remain posted for 30 days. Failure to maintain posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with the licensee, Zhanneta Karapetyan.

SUPERVISOR'S NAME: Garfield Leung	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Catrina Quimbo	TELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 04/12/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/12/2023

LIC809 (FAS) - (06/04)

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