<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414001890
Report Date: 04/04/2024
Date Signed: 04/04/2024 03:30:15 PM


Document Has Been Signed on 04/04/2024 03:30 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 CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066



FACILITY NAME:KOPTI, MARY FARIDFACILITY NUMBER:
414001890
ADMINISTRATOR:KOPTI, MARY FARIDFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(650) 630-0151
CITY:FOSTER CITYSTATE: CAZIP CODE:
94404
CAPACITY:14CENSUS: 7DATE:
04/04/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Mary KoptiTIME COMPLETED:
03:45 PM
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 4, 2024 @ approx. 1:30 pm, Licensing Program Analyst (LPA) Maria Olguin-Leon met with Licensee, Mary Kopti for an unannounced annual inspection. The purpose of the inspection was explained. Present today was Licensee, licensee’s two son (one is assistant) and 7 children (4 infants & 3 preschool age). All adults present in home have criminal background clearances. Licensee is within capacity/ratios on this day. Daycare hours are Monday– Friday, 8:30 am - 5:30pm.

LPA and Licensee toured the home for health and safety hazards. Day Care Areas: Dining room, kitchen, family room bathroom, master bedroom (napping only), bedroom #2 (napping only), front atrium and backyard. Off Limits Areas: Living room, bedroom #3, master bathroom and garage. LPA approved the addition of Bedroom #2 for napping purposes only and inspected the backyard. Licensee previously had a pool in backyard. Pool has been filled and is covered with a cement. Front outdoor atrium is currently being used for outside play; LPA observed toys in good condition. Cubbies are in dining room to barricade entrance into living room area. Home is well light and has proper ventilation. Kitchen and bathroom cabinets are equipped with childproof locks. Cleaning supplies and other potentially harmful items are stored inaccessible to the children. All electrical outlets are equipped with childproof covers. There are plenty of age-appropriate toys, books, child size furnishings, learning material, and playpens. LPA observed backyard to have ride on toys, LPA advised licensee to provide other toys for outside play. Outdoor backyard has a cement patio. Backyard is surrounded with a 5 ft. fence. There are no spas, pools, or other bodies of waters.

Home is equipped with a dual smoke/carbon monoxide detector and a fully charged fire extinguisher. Isolation area for ill children will be in family room on couch and away from other children. First aid kit is fully stocked with supplies. Licensee uses a cell phone on the premises. Per licensee there are no weapons or firearms in the home. Licensee provides sheets for playpens and are washed weekly or when soiled. LPA discussed the importance of having logs available for LPA to confirm 15-minute sleep check, Licensee understood and will document sleeping logs.

Cont. page 2…
SUPERVISOR'S NAME: Marie RodriguezTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Maria Olguin-LeonTELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:
DATE: 04/04/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/04/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 8


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BRUNO CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: KOPTI, MARY FARID
FACILITY NUMBER: 414001890
VISIT DATE: 04/04/2024
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
26
27
28
29
30
31
32
Page 2...

LPA reviewed 6 children’s records and 1 staff record. Children’s files included LIC282. LPA reminded to have immunization records and parent’s rights LIC995A completed. Licensee CPR/FA expires 03/2026. Licensee Mandated Reporter training expires 03/2026. Licensee provides Breakfast, Lunch, and afternoon snacks for some children in care and some children. LPA reminded Licensee to label children's food/bottles brought from home. LPA observed Childcare License, Emergency Disaster Plan 610A and Parent's rights posted at entrance of home. Per licensee last emergency drill was conducted on 09/2023, LPA reminded Licensee to properly document drills.

Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. 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: https://www.ada.gov/resources/child-care-centers/.

The Licensee was reminded about the Provider Information Notices (PINs) on the CCLD website. Licensee was informed that as of September 1, 2016, a person may not be employed or volunteer at a childcare facility unless he or she has been immunized against influenza, pertussis, and measles or qualifies for an exemption pursuant to Health and Safety code 1596.7995 and 1597.662.

As of January 1, 2018, all staff must complete Mandated Reporter Training every two years. LPA reminded licensee about Mandated Reporter training available www.mandatedreporterca.com

Cont. page 3...
SUPERVISOR'S NAME: Marie RodriguezTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Maria Olguin-LeonTELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 04/04/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/04/2024
LIC809 (FAS) - (06/04)
Page: 2 of 8
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BRUNO CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: KOPTI, MARY FARID
FACILITY NUMBER: 414001890
VISIT DATE: 04/04/2024
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
26
27
28
29
30
31
32
Page 3...

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. LPAs also informed licensee [or facility representative] 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.

To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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/inspection-process.



Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

During the exit interview, the LICENSEE, Mary Kopti confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS on 04/02/2024.

No deficiencies issued at this time, under Title 22 Division 12 of the California Code of Regulations.

A notice of site visit was given and must remain posted for 30 days. Failure to comply with 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: Marie RodriguezTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Maria Olguin-LeonTELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 04/04/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/04/2024
LIC809 (FAS) - (06/04)
Page: 3 of 8