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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 195700237
Report Date: 03/07/2024
Date Signed: 03/07/2024 11:33:53 AM

Document Has Been Signed on 03/07/2024 11:33 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:AZARYAN FAMILY CHILD CAREFACILITY NUMBER:
195700237
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 0DATE:
03/07/2024
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
07:30 AM
MET WITH:Armine Azaryan, ApplicantTIME COMPLETED:
11:40 AM
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Pre-Licensing Visit Conducted In Armenian
Licensing Program Analyst (LPA) Silva Garibyan conducted a pre-licensing inspection on 03/07/2024 at 7:30AM. LPA met with Armine Azaryan, applicant who guided analyst on a tour of the facility. The applicant is requesting a small family child care home license with a capacity of 8. Per applicant operation hours will be Monday to Friday from 7:30 am to 6:00 pm. Applicant states she will care for children newborn to 13 years of age. Entrance Checklist was provided to the applicant. Applicant stated that a cell phone with active service in the home will be the main contact number while children are in care. Family members residing in the home include two adults ( applicant and her husband) and three children ( 7, 6, and 4 years old). Applicant was informed that her children under 10 years of age, count in her capacity whenever they are present.

All areas identified on the facility sketch were inspected, including but not limited to, off limit areas. This is a single story home that consists of 3 bedrooms, 2 bathrooms, living room, dining room, kitchen, laundry room, attached garage. There is a pool in the back yard. LPA toured the backyard area to ensure that the pool fencing meets the Title 22 requirements. LPA observed the pool fencing to be 5 feet high, have a self latching gate that swings away from the pool and has a self latching device that is located no more than 6 inches from the top of the fence. The mesh fence with additional railing addition encloses the pool on two sides. The other two sides are enclosed by the property wall.

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SUPERVISORS NAME: Betty Bell
LICENSING EVALUATOR NAME: Silva Garibyan
LICENSING EVALUATOR SIGNATURE: DATE: 03/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/07/2024
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: AZARYAN FAMILY CHILD CARE
FACILITY NUMBER: 195700237
VISIT DATE: 03/07/2024
NARRATIVE
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The spacing between railings is no more than 4 inches. The distance between the ground and the bottom of the fence is no more than 4 inches from the hard surface(concrete). The mesh fencing is sturdy and capable of withstanding the impact of children's toys including bicycles. There are no other bodies of water on the premises. LPA took photos to document in the file. The pool fence meets Title 22 regulations.

Per applicant, the children will use the following areas: Living room, Dining room, and bathroom (1) in the hall way.

The front door will be used to access the dining/play room. Kitchen cabinets were observed and inspected. The stove, refrigerator, sink and counter space area were observed and inspected. Knifes and sharp objects observed to be made inaccessible to the children in care. Applicant confirmed that facility will be providing meals and snacks. LPA discuss food preparation, storage and ensuring a log and information regarding dietary restrictions and allergies are kept up to date.

Applicant has submitted a disaster plan. The applicant has completed preventive health and safety/Childhood Nutrition/ Lead Exposure Prevention and Mandated Reporter training (completed on 10/16/2023). The applicant has current pediatric CPR/First Aid training completed on 10/21/2023. Bedrooms were observed and inspected. Applicant has designated Bedroom(1), Bedroom(2), Bedroom (3), Bathroom(2), Laundry room, and Garage as OFF LIMIT to the children in care. LPA observed bedroom doors with safety knob/locks making off limit areas inaccessible. The bathroom that children will use is in the hall way. A toilet, a sink and a bath tub was observed. The bathroom was observed to be free of hazards. Page 2 of 5

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

DATE: 03/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/07/2024
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: AZARYAN FAMILY CHILD CARE
FACILITY NUMBER: 195700237
VISIT DATE: 03/07/2024
NARRATIVE
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 Children will utilize the back yard to play. Applicant is stating that when children are having outside time she will ensure 100% supervision and never leave children unattended.

Dining/Play room was observed to have children size tables and chairs, napping cots, a play yard, and a variety of age appropriate materials. LPA observed emergency water and first aid kit in the kitchen. Children will eat and sleep in the dining/play room and in the living room. LPA observed applicant test the carbon monoxide/ smoke detector in dining room. LPA observed a fire extinguisher (2A10BC) mounted in the dining/play room. All electrical outlets in the home were covered. There is a fire place in the living room. Fire place has a screen, preventing access to the fire place.

Applicant owns the home and provided proof of control of property (Deed of Trust and Mortgage Statement).



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, 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: 03/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/07/2024
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: AZARYAN FAMILY CHILD CARE
FACILITY NUMBER: 195700237
VISIT DATE: 03/07/2024
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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.
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. Entrance Checklist was provided to the applicant.
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-andresources/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.
On 12/13/2023, 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. Page 4 of 5
SUPERVISORS NAME: Betty Bell
LICENSING EVALUATOR NAME: Silva Garibyan
LICENSING EVALUATOR SIGNATURE:

DATE: 03/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/07/2024
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: AZARYAN FAMILY CHILD CARE
FACILITY NUMBER: 195700237
VISIT DATE: 03/07/2024
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Applicant was informed of the MyChildCarePlan.org site, 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.

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



Exit interview conducted and report was reviewed with the applicant, Armine Azaryan.

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

DATE: 03/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/07/2024
LIC809 (FAS) - (06/04)
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