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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 195700103
Report Date: 11/08/2024
Date Signed: 11/08/2024 09:58:17 AM

Document Has Been Signed on 11/08/2024 09:58 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:BAKHSHIYAN FAMILY CHILD CAREFACILITY NUMBER:
195700103
ADMINISTRATOR/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 0DATE:
11/08/2024
TYPE OF VISIT:Annual/RandomANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:05 AM
MET WITH:Lilit Bakhshiyan, LicenseeTIME VISIT/
INSPECTION COMPLETED:
10:15 AM
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On 09/26/2024, beginning at 08:00 AM, Licensing Program Analysts (LPA) Elicia Calvillo conducted an announced Annual and Capacity Increase inspection at 16823 Hiawatha Street, Granada Hills, CA 91344. Licensee is applying for a large Family Child Care Home Capacity Increase, anticipating caring for children from ages 2 months to 16 years of age. LPA met with Lilit Bakhahiyan, Licensee, who guided LPA on a tour of the inside and outside of the home. There were no children present. LPA provided Licensee with a copy of the LIC 125 Entrance Checklist to help facilitate the inspection. Facility operation hours are Monday through Sunday 01:00 AM - 11:00 PM.

The Licensee provided proof of control property.

As drawn on the facility sketch and observed during the tour, the facility is a one-story residence consisting of a living/ dining room, kitchen, master bedroom, 2 bedrooms, 3 bathrooms, and attached garage. There is a fenced front yard that will be used for dropping off and picking up children. There is a fenced outdoor play area in the back of the house with a pool.

LPA observed the following inside areas will be used for child care: living / dining room and bathroom #1 will be used for child care activities. Living/dining room will be used for indoor play, activities, sleeping, and eating. LPA observed 8 chairs, table, 8 cots and Licensee will purchase additional items as enrollment increases. LPA observed toys and play items that are safe, clean, and appropriate for the ages of the children.

Bathroom#1 located in hallway near the entrance will be used for children. The vanity cabinet holds paper products, and no hazards were observed. LPA observed that the bathroom that children will use was safe and sanitary.

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SUPERVISORS NAME: Rita Ramos
LICENSING EVALUATOR NAME: Elicia Calvillo
LICENSING EVALUATOR SIGNATURE: DATE: 11/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/08/2024
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 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: BAKHSHIYAN FAMILY CHILD CARE
FACILITY NUMBER: 195700103
VISIT DATE: 11/08/2024
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Licensee stated that when a child shows signs of an illness the child will isolated in the living/dining room away from other children.

There is a smoke detector and a carbon monoxide detector in the living / dining room and were tested and are operable. There is a working fire extinguisher, the valve on the required 2A 10BC fire extinguisher indicates fully charged and was serviced on 06/10/2024.

LPA reviewed with Licensee that fire extinguisher type 2A:10BC must be serviced annually. Smoke and carbon monoxide detectors should be checked periodically, and batteries should be replaced.

LPA reviewed with Licensee that all homes shall conduct fire and disaster drill at least once every six months and document the date and time of each drill. The last fire and disaster drill was conducted on 08/22/2024.

There is adequate central heating and ventilation for safety and comfort.

The back yard can be accessed from a sliding door with an alarm in the living / dining room door. The outdoor play area accessible to children has cement pavers and is fenced. LPA observed outdoor toys that are safe and appropriate for the ages of the children.

LPA did observe a swimming pool. There is a mesh and metal stake fenced pool; the fence is in good repair and completely surrounds the pool, is designed and installed so children could not remove any portion. LPA measured the fence and it is at least five feet high, constructed so that it does not obscure the pool from view, and is not easily climbable by children. LPA observed the pool gate swings away the pool, self-closes, and is self-latching. Self-latching device is located on the top of the gate. There is no direct access from the home to the pool. Licensee agrees that the fencing will remain in place whenever licensed care is provided, and so long as the mesh fence makes the swimming pool inaccessible to children as determined by licensing staff.

LPA observed the following inside areas are not used for child care; kitchen, master bedroom, bedroom #1, bedroom #2, bathroom #2, bathroom #3 and attached garage. Licensee has made the areas inaccessible to children with the use of door locks.
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SUPERVISORS NAME: Rita Ramos
LICENSING EVALUATOR NAME: Elicia Calvillo
LICENSING EVALUATOR SIGNATURE:

DATE: 11/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/08/2024
LIC809 (FAS) - (06/04)
Page: 2 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: BAKHSHIYAN FAMILY CHILD CARE
FACILITY NUMBER: 195700103
VISIT DATE: 11/08/2024
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Criminal Record Clearance - Family Child Care Homes Lilit Bakshiyan, Licensee 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, 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 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.

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 http://www.cpsc.gov and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

LPA did not observe the following items during the inspection: Infant Walkers, Johnny Jumpers, Saucer Chairs, Trampolines and/or any other item that fall into these categories are not permitted in a family child care facility.

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) or (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.

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.



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SUPERVISORS NAME: Rita Ramos
LICENSING EVALUATOR NAME: Elicia Calvillo
LICENSING EVALUATOR SIGNATURE:

DATE: 11/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/08/2024
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: BAKHSHIYAN FAMILY CHILD CARE
FACILITY NUMBER: 195700103
VISIT DATE: 11/08/2024
NARRATIVE
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Detergents, cleaning compounds, medications, and other items which could pose a danger to children were observed to be inaccessible to children. The licensee states that there are no poisons in the home and LPA informed licensee that storage areas for poisons must be locked with a key or combination lock.

Per Licensee, there are no firearm or other weapons on the premises and LPA did not observe any firearms or weapons on the premises during the inspection. Per Licensee there are no pets on the premises and LPA did not observe any pets on the premises.

Licensee was reminded that children in care are to be supervised at all times. LPA reviewed with Licensee that children eating may only be in highchairs and that car seats are utilized only for transportation and not for sleeping, and made aware that children shall not be left in parked vehicles.

LPA reviewed with Licensee that regulation prohibits smoking in a private residence licensed as a family child care home. Per Licensee, no one smokes in the home.

LPA reviewed with Licensee 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.



LPA reviewed with Licensee reporting and notification requirements for any unusual incident or injury to the Child Care Regional Office by telephone within 24 hours and within 7 days complete a written report, LIC 624B Unusual Incident/Injury Report.

The Licensee has completed training on preventive health practices including Pediatric First Aid and CPR. The licensee's Pediatric First Aid and CPR expires on 02/2025. There are first aid supplies available. The Licensee does have proof of immunization against influenza, pertussis, and measles. The Licensee does have proof of the Mandated Reporter AB 1207 compliant Child Care Training Certificate.

Emergency Disaster Plan, Earthquake Prepardness, Parent’s Rights Poster and the Facility License were observed to be posted.



LPA reviewed a sample of children’s files and observed files were complete and documented on the LIC857.
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SUPERVISORS NAME: Rita Ramos
LICENSING EVALUATOR NAME: Elicia Calvillo
LICENSING EVALUATOR SIGNATURE:

DATE: 11/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/08/2024
LIC809 (FAS) - (06/04)
Page: 3 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: BAKHSHIYAN FAMILY CHILD CARE
FACILITY NUMBER: 195700103
VISIT DATE: 11/08/2024
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On this date, 09/26/2024, the California Attorney General - Megan’s Law website was searched for information on sex offenders required to register with local law enforcement under California's Megan's Law. No registered sex offenders were found at the facility addresses. Under state law, some registered sex offenders are not subject to public disclosure; therefore, they may not have been included in this search. However, the Department conducts a monthly cross reference of each address on record for all registered sex offenders against all CCLD facility addresses pursuant to information shared by California DOJ.

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 platforms. To receive important licensed related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-carelicensing/subscribe and select the Child Care option to receive email communication.



The application will be reviewed for approval Licensing Program Manager prior to capacity increase licensure approval.

Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, no deficiencies are being cited.

A Notice of Site Visit was given and must remain posted for 30 days during the hours of operation after each site visit by a licensing representative. Failure to comply with posting requirement will result in an immediate civil penalty of $100.00.

Exit interview was conducted with Lilit Bakhahiyan, Licensee including, but not limited to Provider Rights, Appeal Procedures and Agencies Consultative Role.

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SUPERVISORS NAME: Rita Ramos
LICENSING EVALUATOR NAME: Elicia Calvillo
LICENSING EVALUATOR SIGNATURE:

DATE: 11/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/08/2024
LIC809 (FAS) - (06/04)
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