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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414004661
Report Date: 10/25/2024
Date Signed: 10/28/2024 08:24:09 AM

Document Has Been Signed on 10/28/2024 08:24 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 CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME:KIDS KONNECT INFANT CARE & PRESCHOOLFACILITY NUMBER:
414004661
ADMINISTRATOR/
DIRECTOR:		NASIRIPOUR, YASHAFACILITY TYPE:
850
ADDRESS:1968 OLD COUNTY ROADTELEPHONE:
(650) 306-1780
CITY:REDWOOD CITYSTATE: CAZIP CODE:
94062
CAPACITY: 21TOTAL ENROLLED CHILDREN: 21CENSUS: 12DATE:
10/25/2024
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:57 PM
MET WITH:Yasha NasiripourTIME VISIT/
INSPECTION COMPLETED:
04:15 PM
NARRATIVE
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On October 25, 2024 @1:55pm, Licensing Program Analysts (LPAs) Maria Olguin-Leon and Jaclyn Naves conducted an unannounced visit to gather information. While gathering information. LPAs observed Director was reluctant to have staff speak to LPAs. While staff were speaking to LPAs, Director kept walking by window gesturing staff to wrap up and questioning staff after meeting with LPAs.

Upon further review LPA's gathered information to support a citation issued under inspection authority.


***See attached page for deficiencies cited against the facility under CCR,Title 22, Div. 12, Chapt. 1.***

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

Exit interview conducted and report was reviewed with Director, Yasha Nasiripour. Appeal Rights were provided.

SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Maria Olguin-Leon
LICENSING EVALUATOR SIGNATURE: DATE: 10/25/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/25/2024
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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Document Has Been Signed on 10/28/2024 08:24 AM - It Cannot Be Edited


Created By: Maria Olguin-Leon On 10/25/2024 at 02:44 PM
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: KIDS KONNECT INFANT CARE & PRESCHOOL
FACILITY NUMBER: 414004661

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/25/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Deficiency Dismissed
Type B
10/25/2024
Section Cited
CCR
101200(b)(1)

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101200 Inspection Authority of the Department (b) The Department has the authority to interview children or staff without prior consent. (1) The licensee shall ensure that provisions are made for private interviews with any children or staff members.

This requirement is not met as evidenced by:



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Facility will create a plan to ensure CCLDs ability to speak to children, staff and parents according to regualtions in Health and Safety code.
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Based on LPAs observations and interviews, LPAs observed Director kept walking by window gesturing staff to wrap up and questioning staff after meeting with LPAs, which poses a potential health, safety or personal rights risk to persons in care.

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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.
SUPERVISOR'S NAME:Marie Rodriguez
LICENSING EVALUATOR NAME:Maria Olguin-Leon
LICENSING EVALUATOR SIGNATURE:
DATE: 10/25/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/25/2024


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