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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434407418
Report Date: 07/12/2023
Date Signed: 07/12/2023 11:18:36 AM

Document Has Been Signed on 07/12/2023 11:18 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
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME:KHAZENI, MANIJEH & BEYK, MOHAMMADFACILITY NUMBER:
434407418
ADMINISTRATOR:KHAZENI & BEYKFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(408) 736-6310
CITY:SUNNYVALESTATE: CAZIP CODE:
94086
CAPACITY: 14TOTAL ENROLLED CHILDREN: 9CENSUS: 0DATE:
07/12/2023
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
10:40 AM
MET WITH:Mohammad BeykTIME COMPLETED:
11:30 AM
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Licensing Program Analysts (LPAs) Mel Matos and Jovani Dillon met with Mohammad Beyk, co-Licensee, for an unannounced case management inspection. No children were present during today's inspection since the day care is closed for the week. Mohammad states that the day care will reopen on Monday July 17, 2023.

Purpose of today's inspection: Licensees have added a permitted 210 sq ft deck and patio cover to the backyard. An updated outdoor sketch and final copy of construction permit from the city of Sunnyvale was provided to LPA Matos prior to today's inspection.

LPAs toured the backyard area of the home, including the new 210 sq ft deck and patio cover during today's inspection. LPAs conclude that the entire backyard, including the 210 sq ft deck and patio, is safe for the children.

A Fire Safety Inspection Request was emailed to the Sunnyvale Department of Public Safety on July 11, 2023. LPAs advised Mohammad that the 210 sq ft deck and patio cover will be approved for day care use once the Department has received the approved/updated Fire Safety Inspection Request from the Sunnyvale Department of Public Safety.

Exit interview conducted and report was reviewed with the Licensee, Mohammad Beyk. No deficiencies issued during today's inspection.

A Notice of Site Visit was given and must remain posted for 30 days.

SUPERVISORS NAME: Diana Stephenson
LICENSING EVALUATOR NAME: Melvin S Matos
LICENSING EVALUATOR SIGNATURE: DATE: 07/12/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/12/2023
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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