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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414000696
Report Date: 02/29/2024
Date Signed: 02/29/2024 04:50:05 PM

Document Has Been Signed on 02/29/2024 04:50 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:COHN, FOROOZANFACILITY NUMBER:
414000696
ADMINISTRATOR:COHN, FOROOZANFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(650) 349-6926
CITY:FOSTER CITYSTATE: CAZIP CODE:
94404
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: DATE:
02/29/2024
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME BEGAN:
12:36 PM
MET WITH:Foroozan CohnTIME COMPLETED:
03:25 PM
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On February 29, 2024 at approximately 12:35 AM, Program Analyst (LPA) Maria Olguin-Leon conducted an unannounced annual inspection and met with licensee Foroozan Cohn, and purpose of inspection was explained. Present in-home today was Licensee, Licensees spouse, helper and 9 preschool age children. Licensee is operating within capacity and ratio requirements on this day. Adults present today have fingerprint clearances. Facility hours of operation are Monday - Thursday, from 7:30AM to 3:00PM and Friday 7:30AM-1:00PM

LPA and Licensee toured the home for health and safety hazards. Home is a two story home. Day Care Areas: family room, playroom, bathroom, kitchen, dining room, deck, and part of backyard. Living room is used for napping purposes only. Children enter daycare through side gate into playroom. Deck is properly gated and has locked gate to prevent access to off limits backyard area. Off-limits areas: entire 2nd floor, main entryway foyer, office, garage, and side of backyard, which is properly fenced off. There are child proof gates located in kitchen and staircase. Fireplace in living room is properly barricaded. Home is clean, well light and has proper ventilation. Cleaning supplies and other potentially harmful items are stored inaccessible to children and behind child proof cabinets. All electrical outlets are secured with child proof covers. There are plenty of age-appropriate toys, books, child size furnishings, learning material, and sleeping mats. Backyard has plenty of age-appropriate play toys, ride one toys, playhouses, small slide/climbing structure, and playhouse. Backyard is equipped with artificial grass, square rubber tiles and grass to cushion falls. Lagoon behind home is properly and completely fenced off with a sturdy five foot wire fence barricading bodies of water and a wood fence on side of home.

Home is equipped with a working carbon monoxide detector, smoke detector and a fully charged fire extinguisher. Isolation area for ill children will be in playroom or dining room and away from other children. LPA reviewed first aid kit and kit is fully stocked. Licensee uses cell phone on the premises and understands phone must remain on premises during childcare hours. Per licensee, there are no weapons or firearms in the home. Licensee provides sheets for sleeping mats and washes them on a weekly basis or as needed.

Cont. page 2…
SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Maria Olguin-Leon
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: COHN, FOROOZAN
FACILITY NUMBER: 414000696
VISIT DATE: 02/29/2024
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LPA reviewed 6 children’s record and 1 staff record, which were all complete with all required documents. Licensee maintains an updated Children’s roster. Licensees CPR/FA expires 01/2025. License Mandated Reporter training expires 01/2026. Licensee provides breakfast, lunch, and two snacks to children in care. LPA reminded Licensee to label children's food/bottles brought from home. LPA observed Childcare License, Emergency Disaster Plan (LIC610A) and Parent's rights posted. Per licensee, last emergency drill was conducted in September, 2023. LPA reminded Licensee to properly document conducted emergency drills. Licensee carries liability insurance via Markel.

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.

This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see PIN 22-02-CCP. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514- 0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA are 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. LPA reviewed AB 1207 with the Licensee.

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...
SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Maria Olguin-Leon
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)
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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 CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: COHN, FOROOZAN
FACILITY NUMBER: 414000696
VISIT DATE: 02/29/2024
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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 licensees 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 childcare by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California.


During the exit interview, the LICENSEE, Foroozan Cohn confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

No deficiencies were issued today 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.

Exit interview conducted and report was reviewed with the licensee, Foroozan Cohn.
SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Maria Olguin-Leon
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)
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