414001890-4-12-2023-05-CC-MOLN-CQTNYA-20230412105225

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 414001890
Report Date: 04/12/2023
Date Signed: 04/12/2023 10:52:37 AM

Document Has Been Signed on 04/12/2023 10:52 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:	KOPTI, MARY FARID		FACILITY NUMBER:	414001890
ADMINISTRATOR:	KOPTI, MARY FARID		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(650) 630-0151
CITY:	FOSTER CITY	STATE: CA	ZIP CODE:	94404
CAPACITY:	14	CENSUS: 4	DATE:	04/12/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	08:24 AM
MET WITH:	Mary Kopti		TIME COMPLETED:	11:15 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 11, 2023 at approximately 8:20 am, Licensing Program Analyst (LPA) Maria Olguin-Leon, conducted an unannounced, annual inspection. LPA met with licensee, Mary Kopti, and explained the purpose of the inspection. Present during the visit included licensee, licensee's adult son and 6 enrolled children (4 infants and 2 preschool age). All adults living and/or working in the home have criminal record clearance on file. Hours of operation are Monday-Friday from 8:00am to 5:30pm. LPA and Licensee toured the home for health and safety hazards. The home is owned by Licensee and is a single level home. The DAY CARE AREAS are family room, dining room, kitchen, master bedroom (for napping only) and bathroom #1. The OFF-LIMIT AREAS are Living room, bedroom #1 & #2, master room bathroom and garage. Backyard is currently off limits and pool has been removed and covered with concrete. Licensee is in processes of cleaning up and setting backyard for daycare usage and currently uses front atrium for outdoor play. LPS observed ride on toys in front atrium in good repair. All off limit areas are barricaded with child safety locked doors and/or child safety gates. Fireplace in living room is properly barricaded with children’s cubbies unit. LPA observed home to be in good repair with proper temperature and ventilation. There were a variety of toys and equipment that were in good working condition. There are plenty of playpens for napping, Licensee provides sheets that are washed weekly. LPA observed cleaning supplies, poisons, and other chemicals to be stored in garage and on top of counter inaccessible to children. Bathroom for children's use was observed to be clean and in proper working condition. Electrical outlets in home were observed to be properly covered with furnishings and made inaccessible. Licensee provides meals for children in care and food was properly stored to avoid contamination. Home is equipped with a first aid kit and fully charged fire extinguisher. Per licensee, smoke detector is a dual smoke/carbon monoxide detector. Licensee tested detector and was observed to be in working condition. (Continue Report on Page 2...)

SUPERVISOR'S NAME: Ali Zebila	TELEPHONE: (650) 266-8817
LICENSING EVALUATOR NAME: Maria Olguin-Leon	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: KOPTI, MARY FARID	FACILITY NUMBER: 414001890
	VISIT DATE: 04/12/2023

NARRATIVE

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LPA reviewed six children's records for all documentatinon> LPA reminded Licensee to have parents sign parents rights form and to file in children's folders. Licensee's Pediatric First Aid/CPR will expire 12/2023. Last emergency drill was conducted 1/02/2022. Emergency drills are conducted at least once every six months and are properly logged. Licensee has licensing documentation properly posted and available for review. LPA also reminded Licensee to document sleep logs for all children under the age of 2 yrs. old. LPA provided LIC126.

LPA reminded licensee about Mandated Reporter training available www.mandatedreporterca.com. Licensee was reminded Mandated Reporter training must be renewed every 2 years and all staff who directly work with children must complete training.

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: www.ada.gov/childqanda.htm.

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.

(Continue Report on Page 3...)

SUPERVISOR'S NAME: Ali Zebila	TELEPHONE: (650) 266-8817
LICENSING EVALUATOR NAME: Maria Olguin-Leon	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)

Page: 2 of 5

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: KOPTI, MARY FARID	FACILITY NUMBER: 414001890
	VISIT DATE: 04/12/2023

NARRATIVE

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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.

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, Mary Kopti.

SUPERVISOR'S NAME: Ali Zebila	TELEPHONE: (650) 266-8817
LICENSING EVALUATOR NAME: Maria Olguin-Leon	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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