<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 195700077
Report Date: 12/03/2024
Date Signed: 12/04/2024 06:30:18 AM

Document Has Been Signed on 12/04/2024 06:30 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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:KOTANJYAN FAMILY CHILD CAREFACILITY NUMBER:
195700077
ADMINISTRATOR/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 2DATE:
12/03/2024
TYPE OF VISIT:Annual/RandomANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:00 AM
MET WITH:Licensee / Anna KotanjianTIME VISIT/
INSPECTION COMPLETED:
03:45 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
On 12/3/24, at 8AM, Licensing Program Analyst (LPA) Joe Katrdzhyan conducted an announced capacity increase and an unannounced Annual/Random inspection to the above facility. Upon arrival, LPA disclosed the purpose of the inspection and met with Applicant/Licensee: Anna Kotanjyan, who guided the LPA on a tour of the facility. Adults in the home were discussed and all have criminal record clearance. Also present was Licensee's Daughter / Tina Grigoryan. There were 2 day care children present during today’s inspection. Licensee states that there are currently nine (9) children enrolled. The children's roster was reviewed and is current. Per licensee, the facility’s days/hours of operation are Monday - Sunday, from 7AM - 10PM. Emergency Disaster Plan, License, and Parents’ Rights were posted at the time of inspection. Disaster drill log was also available during today’s inspection, last disaster drill was conducted on 9/13/24. Family members residing in the home include the Licensee, Licensee's husband, and Licensee's adult son.

This is a two story home which consists of 4 bedrooms, 4 and 1/2 bathrooms, living room and dining room/ kitchen. The home has an attached garage. The washer/dryer are located inside the garage. There is a fireplace located in the living room which has been made inaccessible to children in care by a secured metal screen/barrier. Per Licensee, the fireplace is not being used. Areas used by the children include the living room, dining room/kitchen, bedroom 1 and half (1/2) bathroom, which are located on the first floor. Per Licensee, areas off limits to children on the first floor include the garage and bathroom 1. Per Licensee, the garage and bathroom 1 are locked at all times, making it inaccessible to children. Per Licensee, all areas located on the second floor (including the stairs) are off limits to children. The second floor consists of bedrooms 2 through 4, bathrooms 2 through 4 and a walk in closet (located in the hallway). LPA observed the stairs to be barricaded with the use of a child gate.

All areas identified on the facility sketch as accessible to children were inspected to ensure that they are clean and orderly with ventilation and heating for the safety of the children. There is a working cell phone


Pg. 1 of 4
SUPERVISORS NAME: Rita Ramos
LICENSING EVALUATOR NAME: Joe Katrdzhyan
LICENSING EVALUATOR SIGNATURE: DATE: 12/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/03/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 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: KOTANJYAN FAMILY CHILD CARE
FACILITY NUMBER: 195700077
VISIT DATE: 12/03/2024
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
maintained in the home. LPA observed age appropriate toys, free of loose and sharp parts. LPA observed electrical cover outlets all through the home. Detergents, cleaning compounds, medications, and other items which can pose a danger to children are inaccessible. The Licensee states that there are no poisons in the home. The Licensee does understand that poison must be locked with a key or combination lock. The Licensee was advised that inaccessibility of hazards must be constantly reassessed depending on the children in care. Per licensee, there are no pets and LPA did not observe any pets at the time of visit. Per Licensee, isolation area for sick children is in bedroom 1. The main entry door is used to enter the facility. The home is not equipped with surveillance cameras. LPA observed cots at the facility for napping purposes. LPA did not observe cribs or play yards as Licensee does not have infants in care at this time. LPA advised that there shall be one crib or play yard for each infant who is unable to climb out of the crib or play yard. Licensee is aware and understands that prior to admission of infants, Licensee will purchase cribs and or play yards.

The Children utilize the back yard to play. The back yard is fully fenced. The off limit areas located in the backyard were made inaccessible with the use of a gate/fence and locked. LPA advised Licensee that outdoor supervision is required at all times. LPA observed age appropriate toys free of loose and sharp parts available for the children in the backyard and all trees, shrubs, and plants are maintained. Per Licensee, there are no weapons, firearms in the home. Home does not have a swimming pool. LPA observed no bodies of waters.

Per licensee, the facility provides food for children in care (breakfast, AM snack, lunch, PM snack and dinner). Food preparation areas were toured for safety, cleanliness and proper equipment.



The valve on the required 2A 10BC fire extinguisher indicates fully charged. Smoke and carbon monoxide detectors are in operable condition. The First Aid kit was inventoried for necessary supplies. The Licensee has current Pediatric First Aid and CPR. Proof of immunization against influenza, pertussis, and measles was readily available during today’s inspection. The Licensee has also taken the Mandated Reporter Training.

— Pediatric First Aid and CPR Card valid until: 11/22/2026
— Mandated Reporter AB1207 Completed: 2/3/2025

Pg. 2 of 4

SUPERVISORS NAME: Rita Ramos
LICENSING EVALUATOR NAME: Joe Katrdzhyan
LICENSING EVALUATOR SIGNATURE:

DATE: 12/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/03/2024
LIC809 (FAS) - (06/04)
Page: 2 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: KOTANJYAN FAMILY CHILD CARE
FACILITY NUMBER: 195700077
VISIT DATE: 12/03/2024
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Incidental Medical Services (IMS) are not currently being provided. Licensee is aware that an IMS plan is required to be submitted to the licensing office if they provide any of these services. Information regarding Americans with Disability Act (ADA) can be obtained by contacting US Department of Justice toll free ADA Information line at (800) 514-0301(voice), (800) 514-0383 (TDD) and website link https://www.ada.gov/childqanda.htm.

LPA advised that per FCCH regulation, Section 102417(a) Operation of A Family Child Care Home: 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.

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.

Rooms that are off-limits need to be made inaccessible during operating hours. NO smoking, NO infant walkers, NO Johnny jumpers, NO saucer chairs, NO incline sleepers and any other item that falls into that category are permitted in the facility. Effective January 1, 2010, licensees of family child care homes are required to ensure that at least one staff member with current training in pediatric first aid and pediatric CPR is on site at all times when children are present.



LPA discussed the safe sleep regulations with Licensee 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.

Pg. 3 of 4

SUPERVISORS NAME: Rita Ramos
LICENSING EVALUATOR NAME: Joe Katrdzhyan
LICENSING EVALUATOR SIGNATURE:

DATE: 12/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/03/2024
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: KOTANJYAN FAMILY CHILD CARE
FACILITY NUMBER: 195700077
VISIT DATE: 12/03/2024
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
LPA reviewed and issued the LIC 311D - Forms/Records to Keep in Your Family Child Care Home. Mandatory Forms for the children’s files and staff files, requirements for fire drills, earthquake drills and documentation were discussed. Role and responsibilities of being a Mandated Reporter were reviewed. The Licensee was advised how to access forms and Regulations online at www.ccld.ca.gov. Licensee was made aware that it is his/her responsibility to know the regulations as well as anyone who assists in providing care.

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. Volunteers are encouraged but not required to take the training. Website: http://www.mandatedreporterca.com/http://www.mandatedreporterca.com/

Senate Bill 792: this bill, commencing September 1, 2016, prohibits a person from being employed or volunteering at a child care facility or family day care if he or she has not been immunized against influenza, pertussis and measles. LPA discussed the influenza waiver during the visit.

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.

MyChildCarePlan.org – Centers and Family Child Care Homes Licensee [or facility representative] 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. Megan’s Law - Family Child Care Homes

Per Licensee, there are no Registered Sex Offenders living in the home.


The facility was found in compliance per Title 22 regulations, no deficiencies were issued during today's visit. There were no corrections requested during this visit.
A notice of site visit was given and must remain posted for 30 days.
Exit interview was conducted, report was reviewed with the Licensee and copies provided.
Final license determination will be made upon review by the Licensing Program Manager.
Pg. 4 of 4
SUPERVISORS NAME: Rita Ramos
LICENSING EVALUATOR NAME: Joe Katrdzhyan
LICENSING EVALUATOR SIGNATURE:

DATE: 12/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/03/2024
LIC809 (FAS) - (06/04)
Page: 4 of 4