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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414001707
Report Date: 05/05/2026
Date Signed: 05/05/2026 12:15:47 PM

Document Has Been Signed on 05/05/2026 12:15 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:KARAPETYAN, ZHANNETA S.FACILITY NUMBER:
414001707
ADMINISTRATOR/
DIRECTOR:		KARAPETYAN, ZHANNETA S.FACILITY TYPE:
810
ADDRESS:TELEPHONE:
(650) 758-1518
CITY:DALY CITYSTATE: CAZIP CODE:
94015
CAPACITY: 14TOTAL ENROLLED CHILDREN: 10CENSUS: 9DATE:
05/05/2026
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:37 AM
MET WITH:Zhanneta KarapetyanTIME VISIT/
INSPECTION COMPLETED:
12:30 PM
NARRATIVE
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On May 5, 2026, a Licensing Program Analyst (LPA) Van conducted an announced annual inspection and met with the Licensee, Zhanneta Karapetyan (Janet). The purpose of the inspection was explained, and the licensee granted LPA access to the home. Upon entering the house, LPA observed the children having breakfast. The licensee and an assistant supervised 9 children (1 infant and 8 preschoolers). The licensee complies with her licensed capacity and limitations.

The licensee and individuals residing in the home have had their criminal record clearances verified through the CDSS Background Check System, and they are confirmed to have an eligible clearance status on file.

The childcare areas are the living room, dining area, hallway, bathroom, and backyard. Off-limit areas are the garage, office room (next to the garage), kitchen, and all bedrooms on the upper level. LPA reminded the licensee that all off-limits areas must remain inaccessible to children at all times by using gates or barricades. During the inspection, it was observed that the bathroom is located on a split-level floor, requiring passage up or down approximately 7–8 steps. A mesh safety gate is installed at the bottom of the staircase; however, it was observed to be left unlocked for most of the inspection. LPA advised the licensee that the mesh gate remain securely locked whenever children are present to ensure compliance with safety requirements.



The days and hours of operation are Monday–Friday, 7:30 am–5:00 pm.

LPA toured the child-care areas to assess potential health and safety hazards. The approved child care areas of the home were found to be clean, well-organized, and free of hazards. Age-appropriate educational, imaginative, and sensory toys were available and in good condition. Required safety equipment was present and functioning, including a fully stocked first-aid kit, operational smoke and carbon monoxide detectors, and a mounted 2A:10 BC fire extinguisher that met regulatory standards.
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NAME OF LICENSING PROGRAM MANAGER: Garfield Leung
NAME OF LICENSING PROGRAM ANALYST: Brendon Van
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 05/05/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/05/2026
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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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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Document Has Been Signed on 05/05/2026 12:15 PM - It Cannot Be Edited


Created By: Brendon Van On 05/05/2026 at 11:19 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: KARAPETYAN, ZHANNETA S.
FACILITY NUMBER: 414001707

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/05/2026

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102417(g)(9)(A)1
Operation of A Family Child Care Home
(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (9) Each family child care home shall have a written disaster plan of action prepared on a form approved by the Department. All children, age and ability permitting, and the provider, the assistant provider, and other members of the household, shall be instructed in their duties under the disaster plan. As their age and ability permit, newly enrolled children shall be informed promptly of their duties as required in the plan. (A) Each family child care home shall conduct fire drills and disaster drills at least once every six months. 1. The licensee shall document the drills, including the date and time of each drill. This documentation shall kept at the family child care home.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review and interview, the licensee did not comply with the cited section above, as the licensee did not conduct and document emergency disaster drills at least once every six months. Records reviewed during the inspection showed that the last documented fire and earthquake drills were completed in January 2025. No additional drills had been conducted or recorded since that time. Failure to complete required drills poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 05/22/2026
Plan of Correction
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The licensee must conduct a fire and earthquake drill and document the drill's date, time, and type. The licensee shall submit proof of completion and a written plan describing how ongoing compliance with the six month drill requirement will be maintained by May 22, 2026.

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Garfield Leung
NAME OF LICENSING PROGRAM MANAGER:
Brendon Van
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 05/05/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/05/2026


LIC809 (FAS) - (06/04)
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Document Has Been Signed on 05/05/2026 12:15 PM - It Cannot Be Edited


Created By: Brendon Van On 05/05/2026 at 11:19 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: KARAPETYAN, ZHANNETA S.
FACILITY NUMBER: 414001707

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/05/2026

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102416.3(a)(6)
Alterations to Existing Building or Grounds
(a) Prior to making alterations or additions to a family child care home or grounds, the licensee shall notify the Department of the proposed changed, including, but not limited to, the following: (6) Any change from an area of the family child care home previously identified as "off limits" to an area where care and supervision will be provided to children in care.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the cited section above, which requires that all areas designated as off-limits remain inaccessible to children in care. During the inspection, the LPA observed the licensee’s assistant changing a child’s diaper in a bedroom designated as an off-limits area and not approved by Licensing for child care use. This practice poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 05/22/2026
Plan of Correction
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The licensee must ensure that all off limits areas remain inaccessible at all times and that diaper changing occurs only in areas approved by Licensing. The licensee shall submit a written statement by May 22, 2026, outlining how compliance will be maintained.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Garfield Leung
NAME OF LICENSING PROGRAM MANAGER:
Brendon Van
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 05/05/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/05/2026


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: KARAPETYAN, ZHANNETA S.
FACILITY NUMBER: 414001707
VISIT DATE: 05/05/2026
NARRATIVE
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During the inspection, LPA observed the licensee’s assistant using one of the bedrooms, an area designated as off-limits, to change a child’s diaper.

Cleaning supplies and disinfectants were stored out of children’s reach. The licensee confirmed that no guns or weapons were in the home. No baby walkers, bouncers, or similar prohibited equipment were observed in the childcare areas. The licensee was also reminded that smoking is not permitted in the family child care home.

No cribs or Pack 'n Plays were observed, and no infant sleeping logs were available for review. The licensee reported that one infant is enrolled part-time and that a Pack-N-Play is available in the home but not currently in use, as the infant is typically picked up around 12:00 p.m. LPA reminded the licensee that if an infant needs to nap, a Pack-N-Play must be set up and used. An infant sleep log must be maintained with checks every 15 minutes. LPA also reminded the licensee that sleep sacks are not permitted in the facility.

The backyard is fully fenced and includes a concrete slab area for bike riding and a fenced deck. Within the fenced deck area, there are climbing and sliding play structures. LPA observed that no cushioning material was installed beneath the play structures during the inspection. The licensee stated that soft rubber cushioning pads are placed under the structures when children are playing. The licensee provided LPA with a sample of the rubber cushioning stored in the shed during the visit.

Temporary absence requirements were reviewed with the licensee. LPA reminded the licensee that they must remain on the premises to ensure children are supervised at all times. If the licensee must leave, the temporary absence may not exceed 20% of the facility’s daily operating hours.

All required licensing postings were observed, including the facility License, the Notification of Parents' Rights, and the Earthquake Preparedness checklist.

The licensee has not conducted the required fire and earthquake drills at least once every six months. The most recent drill documentation provided by the licensee reflects a completion date of January 2025.


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NAME OF LICENSING PROGRAM MANAGER: Garfield Leung
NAME OF LICENSING PROGRAM ANALYST: Brendon Van
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 05/05/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/05/2026
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: KARAPETYAN, ZHANNETA S.
FACILITY NUMBER: 414001707
VISIT DATE: 05/05/2026
NARRATIVE
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During the visit, LPA reviewed both children’s and personnel records. Several children’s files were found to be incomplete. Missing documents included the Consent for Medical Treatment form, and multiple files lacked parental signatures on the Emergency Identification Card.

Both the licensee and her assistant have current Pediatric First Aid/CPR certifications and valid mandated reporter training. However, the licensee did not have the required immunization records on file, including documentation for Measles (MMR), Pertussis (Tdap), and Influenza.

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

LPA discussed the safe sleep regulations with the Licensee and discussed the Child Care Licensing Safe Sleep web page https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed the 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.


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NAME OF LICENSING PROGRAM MANAGER: Garfield Leung
NAME OF LICENSING PROGRAM ANALYST: Brendon Van
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 05/05/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/05/2026
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: KARAPETYAN, ZHANNETA S.
FACILITY NUMBER: 414001707
VISIT DATE: 05/05/2026
NARRATIVE
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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.

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

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.

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

See LIC 809D for deficiencies cited today.

A notice of site visit was given and must remain posted for 30 days.

An exit interview was conducted, and the report was reviewed with the licensee, Zhanneta Karapetyan.

NAME OF LICENSING PROGRAM MANAGER: Garfield Leung
NAME OF LICENSING PROGRAM ANALYST: Brendon Van
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 05/05/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/05/2026
LIC809 (FAS) - (06/04)
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