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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414000696
Report Date: 02/23/2023
Date Signed: 03/01/2023 08:42:14 AM

Document Has Been Signed on 03/01/2023 08:42 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:COHN, FOROOZANFACILITY NUMBER:
414000696
ADMINISTRATOR:COHN, FOROOZANFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(650) 349-6926
CITY:FOSTER CITYSTATE: CAZIP CODE:
94404
CAPACITY: 14TOTAL ENROLLED CHILDREN: 12CENSUS: 11DATE:
02/23/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:13 AM
MET WITH:Foroozan CohnTIME COMPLETED:
02:00 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 February 23rd, 2023 at 11:15am, Licensing Program Analyst (LPA) Maria Olguin-Leon met with Licensee, Foroozan Cohn, for an unannounced annual visit. Present for today’s visit were Licensee, Husband, Licensee's son, helper (Sina) and 11 preschool age children.Capacity and ratio requirements of children was observed in compliance today. Hours of operations are Monday-Thursday 7:30AM - 3:00PM, Friday 7:30AM-1:00PM.

LPA and Licensee toured the home for health and safety hazards. Licensees own this two-story home. On limit areas are: Family room, bathroom, and playroom, kitchen is walk through area to bathroom and playroom. Children daycare home through side gate into playroom and have access to backyard nearest playroom. Deck is used for outdoor time. Living room is only used for napping. Off-limits areas: entire 2nd floor, and main entryway, office, and side of backyard, which is fenced off. The home is clean and has proper ventilation. Cleaning supplies and other potentially harmful items are stored inaccessible to the children. There are plenty of age-appropriate toys indoors and outdoors, child size furnishings, learning materials and sleeping mats. Licensee provides and washes sheets on a weekly basis. Outdoor play area is properly and completely fenced with a sturdy five-foot wire fence barricading bodies of water and wood fence on side of home.


LPA reviewed 5 children’s records and all required documents were in children’s files. Helper’s file was reviewed for all required documents. Licensee CPR/First Aid is current and will expire on 01/2025. Mandated Reporting was completed in 2/2022. Licensee provides snacks and hot lunch. Children’s roster was reviewed and is up to date. Last emergency drill was documented on 10/2022. Sick children will be isolated away from other children in walk through kitchen area.

Cont. Page 2...
SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Maria Olguin-Leon
LICENSING EVALUATOR SIGNATURE: DATE: 02/23/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/23/2023
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 2
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: COHN, FOROOZAN
FACILITY NUMBER: 414000696
VISIT DATE: 02/23/2023
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
cont., page 2

The home is equipped with a carbon monoxide detector, smoke alarms and a fully charged fire extinguisher. Home has a working landline and cell phone on site. Per licensee there are no weapons or firearms in the home. Licensee owns a dog with proper immunization records.

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.

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 and Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

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. LPA reviewed AB 1207 with the Licensee. As of January 1, 2018, all staff must complete Mandated Reporter Training every two years. The training can be obtained online at www.mandatedreporterca.com.

LPA encouraged the Licensee to frequently visit our website at www.ccld.ca.gov for licensing regulations and new updates. The Licensee can also email at childcareadvocatesprogram@dss.ca.gov and ask to be added to the email list for the updates.

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.



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 license, Foroozan Cohn.
SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Maria Olguin-Leon
LICENSING EVALUATOR SIGNATURE:

DATE: 02/23/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/23/2023
LIC809 (FAS) - (06/04)
Page: 2 of 2