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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 214200021
Report Date: 02/29/2024
Date Signed: 02/29/2024 12:00:19 PM

Document Has Been Signed on 02/29/2024 12:00 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:BEYKPOUR, NAIMAFACILITY NUMBER:
214200021
ADMINISTRATOR:BEYKPOUR, NAIMAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(415) 380-9880
CITY:MILL VALLEYSTATE: CAZIP CODE:
94941
CAPACITY: 14TOTAL ENROLLED CHILDREN: 10CENSUS: 9DATE:
02/29/2024
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME BEGAN:
09:25 AM
MET WITH:Licensee, Naima BeykpourTIME COMPLETED:
12:15 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 2/29/2024, at approximately 9:25AM, Licensing Program Analyst (LPA) Jonathan Tse conducted an unannounced annual visit at the facility. LPA was granted entry to the facility by Licensee, Naima Beykpour. LPA explained the purpose of the visit. Present during the visit were the Licensee, Licensee’s spouse (A1), a helper (H1), seven preschool age children, and two infants. The facility is in compliance with capacity requirements on this day. The facility’s operating hours are from 8:00AM to 5:00PM, Monday to Thursday, and 8:00AM to 4:30PM on Fridays.

Daycare Areas: Playroom, Office, Bedroom #1 (Master Bedroom), Bedroom #2, Bathroom #1,
Off-limits Areas: Living Room, Kitchen, Dining Area, and Garage.

LPA inspected the home for any health and safety hazards. LPA observed the home to be in clean and orderly condition. The home is equipped with a fully charged 3A40BC fire extinguisher. There is an operational carbon monoxide detector present in the Hallway. Bedroom #2 is used as an infant napping area. LPA observed that there was a crib available for an infant who is unable to climb out of one on their own. It was clear of objects and other loose materials, with nothing hanging over or attached to the side of the crib. Foam mats are available for children who do not need cribs. Sheets are brought from home for children to use and are brought back home once a week for cleaning. Poisons, cleaning detergents, and other chemicals are stored inaccessible to children in care. Children are provided with breakfast, lunch, and AM/PM snacks. Per Licensee, there are no firearms or weapons present in the home.

LPA observed the Backyard to be free of debris and other loose articles. The Backyard is enclosed by a fence that is at least five feet high. There are age-appropriate toys and equipment present. There are no pools or other bodies of water present in the facility.

Continued on Page Two
SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Jonathan Tse
LICENSING EVALUATOR SIGNATURE: DATE: 02/29/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/29/2024
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 3
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: BEYKPOUR, NAIMA
FACILITY NUMBER: 214200021
VISIT DATE: 02/29/2024
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 Two
LPA reviewed two personnel files and nine children’s files. Licensee’s First Aid/CPR certification expires on 7/2025. Licensee’s Mandated Reporter Training expires on 1/2026. All adults working or living in the home have acquired fingerprint clearance and are associated to the facility. LPA observed all children’s files to contain Emergency Identification and Information (LIC700) and Consent for Emergency Medical Treatment (LIC627). There are infant sleeping logs available for review. LPA observed Licensee checking on a sleeping infant during the visit.

The facility license is available for review in the Playroom. LPA advised Licensee to ensure that all required postings are accessible and available for review. Licensee stated that they understood, and that the postings were temporarily taken down due to painting being done in the Playroom.

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 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.

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-andresources/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.
Continued on Page Three
SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Jonathan Tse
LICENSING EVALUATOR SIGNATURE:

DATE: 02/29/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/29/2024
LIC809 (FAS) - (06/04)
Page: 2 of 3
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: BEYKPOUR, NAIMA
FACILITY NUMBER: 214200021
VISIT DATE: 02/29/2024
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 Three
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/.

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, Licensee confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

No deficiencies were cited during today’s visit on 2/29/2024.
A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the Licensee, Naima Beykpour.
SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Jonathan Tse
LICENSING EVALUATOR SIGNATURE:

DATE: 02/29/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/29/2024
LIC809 (FAS) - (06/04)
Page: 3 of 3