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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 195700238
Report Date: 02/12/2024
Date Signed: 02/12/2024 03:10:02 PM

Document Has Been Signed on 02/12/2024 03:10 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:HOVHANNISYAN FAMILY CHILD CAREFACILITY NUMBER:
195700238
ADMINISTRATOR:HOVHANNES HOVHANNISYANFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(818) 919-1619
CITY:BURBANKSTATE: CAZIP CODE:
91504
CAPACITY: 14TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
02/12/2024
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
12:56 PM
MET WITH:Hovhannes Hovhannisyan, ApplicantTIME COMPLETED:
03:30 PM
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On 02/12/24, beginning at 12:56 PM, Licensing Program Analysts (LPAs) Elicia Calvillo, Conducted an announced Pre-Licensing, 2512 N. Myers Street, Burbank, CA 91504. The purpose of the inspection was to ensure that the health, safety, and personal rights as required by Title 22 Regulations governing California Family Child Care Homes will be met by the applicant. Applicant is applying for a small Family Child Care Home, anticipating caring for 8 children from ages 2 years to 12 years of age. The applicant’s current proposed hours of operation are Monday through Friday 7:00 am – 7:00 pm. LPA met with Applicant Hovhannes Hovhannisyan, who guided LPA on a tour of the inside and outside of the home.

Because the applicant rents/leases the home, proof of landlord notification is required. The LPA observed the Property Owner/Landlord Notification form (LIC 9151) that the applicant confirms was provided to the property owner/landlord. The applicant obtained a signed Property Owner/Landlord Consent form (LIC 9149).

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, one bedroom, bathroom, garage and shared outdoor play area..

LPA observed the following inside areas will be used for child care:
Combined Living and Dining room area will be used for child care activities and eating area. Toys and play items are safe, clean, and appropriate for the ages of the children. Electrical outlets have safety covers installed. LPA observed six chairs and one table, applicant plans to order two additional chairs.

Bathroom is located in hallway near living/ dining and bedroom . The vanity cabinet has two drawers with household items, applicant plans to move items or install a safety latch. Electrical outlets have safety covers installed.

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SUPERVISORS NAME: Rita Ramos
LICENSING EVALUATOR NAME: Elicia Calvillo
LICENSING EVALUATOR SIGNATURE: DATE: 02/12/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/12/2024
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: HOVHANNISYAN FAMILY CHILD CARE
FACILITY NUMBER: 195700238
VISIT DATE: 02/12/2024
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Bedroom will be used for sleeping area for napping and isolation when a child is ill; LPA observed 5 cots in storage area, applicant plans to purchase linens and blankets and 3 additional cots. Electrical outlets have safety covers installed and safety latch installed on sliding glass door.

There is one combination smoke / carbon monoxide detector that was tested and operable.

LPA observed the following inside areas are not used for child care:
The Kitchen area is inaccessible to children in care by a baby gate blocking the stove and by child proof latches on cabinets..

LPA observed the following outside areas:
The back yard can be accessed from Living/Dining Room door and through the Bedroom area, which will remain locked. Play area accessible to children is fenced. Outdoor toys and play items are safe and appropriate for the ages of the children. There are conditions that pose a hazard as follows; outdoor Kitchen Area can be accessible to children and the outdoor patio area has 4 outdoor heaters, Applicant plans to install additional gates and move outdoor heaters to a secure area. LPA took pictures.

Front yard is used as a walk way when children enter the home.

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.

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.

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

DATE: 02/12/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/12/2024
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: HOVHANNISYAN FAMILY CHILD CARE
FACILITY NUMBER: 195700238
VISIT DATE: 02/12/2024
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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 child care 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 Address: childcareadvocatesprogram@dss.ca.gov

Reviewed 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

Reviewed only children eating may be in highchairs and that car seats are utilized only for transportation.

Reviewed regulation prohibits smoking in a private residence licensed as a family child care home

Reviewed fire extinguisher type 2A:10BC must be serviced annually. Smoke and carbon monoxide detectors should be checked, and batteries should be replaced.

Criminal Record Clearance - Family Child Care Homes Applicant Hovannes Hovhannisyan 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: Rita Ramos
LICENSING EVALUATOR NAME: Elicia Calvillo
LICENSING EVALUATOR SIGNATURE:

DATE: 02/12/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/12/2024
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: HOVHANNISYAN FAMILY CHILD CARE
FACILITY NUMBER: 195700238
VISIT DATE: 02/12/2024
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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 licensee [or facility representative] 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.

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. Review of records to be maintained - Child Care Centers LPA reviewed with [applicant, licensee, or facility representative] the LIC 311A, Records to Be Maintained at The Facility, for child’s records, personnel records, administrative record.

Applicant 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.

On this date, 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 D

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

DATE: 02/12/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/12/2024
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: HOVHANNISYAN FAMILY CHILD CARE
FACILITY NUMBER: 195700238
VISIT DATE: 02/12/2024
NARRATIVE
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The following list of corrections needs to be completed prior to licensure approval:
  • Secure outdoor Kitchen Area, applicant plans to installed a baby gate.
  • Remove outdoor portable heaters to a secure area.
  • Remove household products / items from bathroom drawer or secure drawer with safety latch.
  • Purchase two additional sleeping cots and 2 additional chairs.
  • Add parent board near front door.

Applicant to correct the above issues by 3/12/2023.
Exit interview conducted and report was reviewed with Applicant Hovannes Hovhannisyan.


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

DATE: 02/12/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/12/2024
LIC809 (FAS) - (06/04)
Page: 4 of 5