195700069-5-22-2023-58-CC-AALA-CS3QW6-20230522123126

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 195700069
Report Date: 05/22/2023
Date Signed: 05/22/2023 12:31:40 PM

Document Has Been Signed on 05/22/2023 12:31 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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME:	HAYRAPETYAN FAMILY CHILD CARE		FACILITY NUMBER:	195700069
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 8	CENSUS:	DATE:	05/22/2023
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME BEGAN:	08:50 AM
MET WITH:	Alvard Hayrapetyan, Applicant		TIME COMPLETED:	12:45 PM

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On 05/22/23 at 8:55 AM, Antonio Almanza, Licensing Program Analyst (LPA), conducted an announced Pre-Licensing site visit. Upon Arrival LPA met with Alvard Hayrapetyan, Applicant. The applicant is applying for a small family child care home to provided services to children ages 0 months to 15 years. The days and hours of operation requested are Monday thru Friday from 7:00 AM to 6:00 PM. The applicants husband and 3 minor children live in the home. All adults living in the home have received a criminal record clearance and are associated.

The home is a 3-story home with 4 bedrooms, 4 bathrooms and attached garage. The first floor consists of living room, kitchen, dining room and bathroom. The second floor has 4 bedrooms and 3 bathrooms. The third floor is a loft with bathroom that is used as an office by the applicant’s husband. The second and third floor will be off limits to children in care. The first floor attached garage (setup for daycare), and attached ADU in the back (set up for day care) will be used for children in care. Applicant is aware that primary care will be provided in the main home and the garage and ADU will only be used for activities.

There are two children’s tables with 8 chairs for children to eat on in the dinning room and 6 cots in the living room for children to sleep in. Licensee is ware that she will need one crib or playpen for each infant in care.

According to the applicant the attached ADU has the same address as the main home and is called a mother-in-law loft. The ADU is composed of living room, kitchen area (attached to the livening room), bedroom, bathroom, and walk in closet. The ADU is setup as a Child Care Center. The floors of the living room/kitchen and bedroom are covered in cushioned interlocking squares. In the living room/kitchen area there is a small refrigerator, stove, and children’s toys along the wall. The bedroom has a futon and children’s toys. Applicant has sufficient toys and equipment to operate a family child care home.

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SUPERVISORS NAME: Betty Bell
LICENSING EVALUATOR NAME: Antonio Almanza
LICENSING EVALUATOR SIGNATURE:	DATE: 05/22/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/22/2023

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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: HAYRAPETYAN FAMILY CHILD CARE	FACILITY NUMBER: 195700069
	VISIT DATE: 05/22/2023

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LPA observed Fire Extinguisher (2A10BC) in the entrance to the attached garage that was purchased on 03/28/23. LPA observed a working Google Nest combination Smoke Detector and Carbon Monoxide detector at the top of the second-floor stairs that share the same ceiling with the entrance of the home. LPA observed a working Google Nest combination Smoke Detector and Carbon Monoxide detectors in 3 of the 4 bedrooms on the second floor. Smoke Detector/Carbon Monoxide detectors were tested and are operable. There is a child safety gate at the bottom and top of the stairs.

Cleaning supplies and medications are kept inaccessible to children. All sharp items and kitchen knives are kept in kitchen cabinet with child safety latch. There is a fireplace in the living room without a screen. The home is clean and orderly with central AC/Heating and ventilation for safety and comfort. LPA observed safe toys and play equipment age appropriate for childcare. Applicant will use cell phone for the childcare and was reminded that the cellphone must always remain in the home when children are in care. During the visit LPA did not observe any weapons or firearms; applicant states there are no weapons or firearms in the home.

The applicant will use the backyard for children in care. The backyard is surrounded by block wall and a large metal sliding gate. The area that the applicant wishes to use for children has been separated with mesh gating that is anchored to the ground and has artificial turf.

The following was discussed with the applicant:
· Applicant was reminded that the applicants 3 children will be considered part of the facilities ratios if they are home during hours of operation.
· The licensee shall be present in the home and shall ensure that children in care are supervised at all times. When circumstances require the licensee to be temporarily absent from the home, the licensee shall arrange for a substitute adult to care for and supervise the children during his/her absence. Temporary absences shall not exceed 20 percent of the hours that the facility is providing care per day.
· In the absence of the licensee a qualified adult must be present supervising the children; a qualified adult is an individual who has a valid and current adult/infant CPR & Pediatric First Aid certification and a valid criminal record clearance associated to the facility license.

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SUPERVISORS NAME: Betty Bell
LICENSING EVALUATOR NAME: Antonio Almanza
LICENSING EVALUATOR SIGNATURE:	DATE: 05/22/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/22/2023

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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: HAYRAPETYAN FAMILY CHILD CARE	FACILITY NUMBER: 195700069
	VISIT DATE: 05/22/2023

NARRATIVE

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· Commencing September 1, 2016, a person shall not be employed or volunteer at a family day care home if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year. The family day care home shall maintain documentation of the required immunization's or exemptions from immunization, as set forth in this section, in the person’s personnel record that is maintained by the family day care home.
· A current roster of children enrolled must be available and maintained for a period of three years, even after children no longer are attending the facility.
· Annual fees must be paid promptly and by the due date or a late fee shall be assessed, and/or the License shall be terminated.
· The fire extinguisher type 2A-10BC must be serviced annually or as often as necessary. Smoke and carbon monoxide detectors should be checked, and batteries should be replaced.
· Changes should be reported the to the Department as soon as they occur such as construction and remodeling. · Telephone number changes and/or if you move from home.
· Any unusual incidents or injuries must be reported to the Department within 24 hours via telephone and within seven (7) days in writing.
· Fire and safety drills must be performed every six months and documented for review by the Department.
· There is no smoking in a home that is licensed as a family day care home, and in those areas of the family day care home where children are present.
· Children and Staff records must be maintained and updated as needed and must be available for review by the Department.
· Saucer chairs, bouncers, walkers, or any similar items are prohibited.
· All adults living and working in the home shall be made of aware of the Departments right to inspection authority, which includes but not limited to the right to enter the home when children are being cared for, interview children and adults and review documentation.
· AB 1207: Beginning on January 1, 2018, this law requires all licensed providers, applicants, directors, and employees to complete training as specified on their mandated reporter duties and to renew their training every two years. Website: www.mandatedreporterca.com
· Pediatric First Aid and CPR must be completed every 2 years.

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SUPERVISORS NAME: Betty Bell
LICENSING EVALUATOR NAME: Antonio Almanza
LICENSING EVALUATOR SIGNATURE:	DATE: 05/22/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/22/2023

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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: HAYRAPETYAN FAMILY CHILD CARE	FACILITY NUMBER: 195700069
	VISIT DATE: 05/22/2023

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The applicant was informed of the Child Care Advocate Program (CCAP) that is administered from within the Community Care Licensing Division. CCAP participates in many community activities and special projects to disseminate information on the State’s licensing role, provide information to the public and parents on childcare licensing, and provide many other helpful resources to the licensees and the public. CCAP’s direct contact information is as followed: Phone number: (916) 654-1541 Email: childcareadvocatesprogram@dss.ca.gov

The applicant does not have Incidental Medical Services (IMS) Plan. Incidental Medical Services (IMS) policy was discussed. For IMS information, see PIN 22-02-CCP. 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: http://www.ada.gov/childqanda.htm

Applicant was reminded that all adults 18 and over living in the home, persons who provide care and supervision to children, and staff who have contact with children, 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.

LPA discussed the safe sleep regulations with applicant 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 applicant 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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SUPERVISORS NAME: Betty Bell
LICENSING EVALUATOR NAME: Antonio Almanza
LICENSING EVALUATOR SIGNATURE:	DATE: 05/22/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/22/2023

LIC809 (FAS) - (06/04)

Page: 4 of 5

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: HAYRAPETYAN FAMILY CHILD CARE	FACILITY NUMBER: 195700069
	VISIT DATE: 05/22/2023

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LPA reviewed with applicant the LIC 311D, Forms/Records to Keep in Your Family Child Care Homes, children’s forms/records, facility forms/records, and information to be posted.

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platform.To receive important licensed-related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

Prior to Licensure the following is required, and the applicant will complete by 06/02/23.

1. Update facility sketch to show the entire lower level of the home, second floor, third floor, evacuations routs, rooms size, windows, doors, smoke/CO detectors locations, and fire extinguisher.
2. Child safety nobs closet in living room and back ADU.
3. Install screen on fireplace in order to make it inaccessible to children.
4. Child covers on the stove of the ADU.
5. LPA to verify that Facility File is complete with all required documents.
6. Licensing Program Manger Approval.

Exit interview conducted and report was reviewed with Alvard Hayrapetyan, applicant.

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SUPERVISORS NAME: Betty Bell
LICENSING EVALUATOR NAME: Antonio Almanza
LICENSING EVALUATOR SIGNATURE:	DATE: 05/22/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/22/2023

LIC809 (FAS) - (06/04)

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