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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 195700069
Report Date: 11/21/2024
Date Signed: 11/21/2024 04:07:21 PM

Document Has Been Signed on 11/21/2024 04:07 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 CAREFACILITY NUMBER:
195700069
ADMINISTRATOR/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 6DATE:
11/21/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:45 PM
MET WITH:Alvard Hayrapetyan, LicenseeTIME VISIT/
INSPECTION COMPLETED:
04:15 PM
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Annual Random Visit Conducted In Armenian

On 11/21/2024 Licensing Program Analyst (LPA) Silva Garibyan conducted a site visit for the purpose of an Annual Random visit. The purpose of this visit is to ensure the standards for a Family Child Care Home are being met in accordance to California Tittle 22 Regulations and California Health and Safety Codes. The licensee was present with six children. The facility has been licensed for Small (8) Family Child Care home license since July of 2023. The licensee is applying for an increase of capacity; Large Family Child Care Home license for a maximum capacity of 14. The Fire clearance was granted on 11/14/2024 by Burbank Fire Prevention Bureau (inspector David Shafrazian). Hours of operation for the facility are 8:00 AM- 5:00 PM Monday- Friday.. Ages served are new born - 14 years old. There is no pool, spa or other bodies of water on the premises. The home is a three story home with four bedrooms, five bathrooms, attached garage, and attached ADU ( consists of living room, kitchen area, bedroom, bathroom, and walk in closet) . The first floor of the main house consists of living room, kitchen, dining room and bathroom. The second floor has four bedrooms and three bathrooms. The third floor is a loft with bathroom that is used as an office. The second, third floors, and the kitchen are off limits and made inaccessible by a child safety gate located at the bottom of stairs and at the kitchen entrance. The first floor, attached garage, and attached ADU in the back used for children in care. Primary care is provided in the main home. The garage and ADU used for activities. There are two children’s tables with eight chairs for children to eat on, eight cots and a play yard in the Dinning room/Living room area, and two children's tables and 8 chairs in the ADU living room. According to Licensee the attached ADU has the same address as the main home and is called a mother-in-law loft. Page 1
SUPERVISORS NAME: Betty Bell
LICENSING EVALUATOR NAME: Silva Garibyan
LICENSING EVALUATOR SIGNATURE: DATE: 11/21/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/21/2024
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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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: 11/21/2024
NARRATIVE
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LPA observed Fire Extinguisher (2A10BC) in the entrance to the attached garage that was serviced on 11/13/24. 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. The First Aid kit was observed, and complete. Individuals residing in the home have been discussed and noted. All adults present in the home have obtained a criminal record clearance or exemption. The bathroom by the garage door and the kitchen was observed free of chemicals or toxic items that can pose danger to children in care. All sharp items and kitchen knives are kept in kitchen cabinet with child safety latch. The outdoor play area/back yard was inspected. The backyard is surrounded by property wall and a large metal sliding gate. The area used for children has been separated with mesh gating that is anchored to the ground and has artificial turf. Children's outdoor play equipment and toys are age appropriate and in good repair. Cleaning supplies and medications are kept inaccessible to children. There is a fireplace in the living room with 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. Licensee uses 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; Licensee states there are no weapons or firearms in the home

LPA observed Licensee's Pediatric CPR and Pediatric First Aid certifications and current Mandated Reporter Training Certificate (completed on 10/16/2024).

The fire drills are done twice a year. Last drill was conducted on 09/09/2024. Licensee provides meals and snacks. LPA discussed food preparation, storage and ensuring a log and information regarding dietary restrictions and allergies are kept up to date.

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SUPERVISORS NAME: Betty Bell
LICENSING EVALUATOR NAME: Silva Garibyan
LICENSING EVALUATOR SIGNATURE:

DATE: 11/21/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/21/2024
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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: HAYRAPETYAN FAMILY CHILD CARE
FACILITY NUMBER: 195700069
VISIT DATE: 11/21/2024
NARRATIVE
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LPA observed in the living room the Parent Board with all necessary posting required ( Facility License (LIC 203), Emergency Disaster Plan (LIC610A), Notification of Parents' Rights Poster (PUB 394), If You see Something Say Something poster. Child Care Facility Roster (LIC9040) was on file.
A review of the children's records was conducted and are found to have the following: LIC 282 Affidavit Liability Insurance, LIC 627/Consent for Medical Treatment, LIC 700/ID and Emergency Information, LIC702, LIC 995A/Parent's Rights, LIC995E/Caregiver Background Check, LIC 9150/Parent Notification, LIC 9212/Parent's Responsibilities, PM 286/Immunization Card. Sleep logs for infants on file.
A review of records indicates that Licensee has immunization records on file for influenza, pertussis and measles. All adults who reside or work in the home have a criminal record clearance or exemption. There are no excluded individuals present at this home.

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 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.

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SUPERVISORS NAME: Betty Bell
LICENSING EVALUATOR NAME: Silva Garibyan
LICENSING EVALUATOR SIGNATURE:

DATE: 11/21/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/21/2024
LIC809 (FAS) - (06/04)
Page: 3 of 4
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: 11/21/2024
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There are no infants are enrolled at this time. LPA discussed the safe sleep regulations with licensees 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 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.
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: https://www.ada.gov/resources/child-care-centers/.

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

During the exit interview, Licensee Alvard Hayrepetyan informed that there are no Registered Sex Offenders living in the facility.

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

Exit interview conducted and report was reviewed with Licensee Alvard Hayrepetyan.
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SUPERVISORS NAME: Betty Bell
LICENSING EVALUATOR NAME: Silva Garibyan
LICENSING EVALUATOR SIGNATURE:

DATE: 11/21/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/21/2024
LIC809 (FAS) - (06/04)
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