195700409-12-17-2024-58-CC-ECAO-DC2VTR-20241217154335

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 195700409
Report Date: 12/17/2024
Date Signed: 12/17/2024 03:43:44 PM

Document Has Been Signed on 12/17/2024 03:43 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:	GEVORGYAN FAMILY CHILD CARE		FACILITY NUMBER:	195700409
ADMINISTRATOR/ DIRECTOR:	HASMIK GEVORGYAN		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(657) 522-2022
CITY:	GRANADA HILLS	STATE: CA	ZIP CODE:	91344
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS: 0	DATE:	12/17/2024
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	01:05 PM
MET WITH:	Hasmik Gevorgyan, Applicant		TIME VISIT/ INSPECTION COMPLETED:	04:00 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 12/17/2024, beginning at 01:05 PM, Licensing Program Analyst (LPA) Elicia Calvillo conducted an announced Pre-Licensing inspection at 10824 Paso Robles Avenue, Granada Hills, CA. 91344. Applicant is applying for a Large Family Child Care Home, anticipating caring for 14 children from ages 0 to 15 years of age. The Applicant’s current proposed hours of operation are Monday through Saturday 07:30 AM – 10:00 PM. LPA met with Hasmik Gevorgyan, Applicant, 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 is a one-story residence consisting of a combined living/ dining/ kitchen, 3 bedrooms, 3 bathrooms, and detached garage converted to an ADU with address 10826 Paso Robles Avenue, Granada Hills, CA.91344. There is a front yard for dropping off and picking up children. There is a fenced outdoor play area in the back of the house. LPA observed the following inside areas will be used for child care: combined living/ dining/ kitchen room, bedroom #1 and bathroom #2 will be used for child care activities. The combined living/ dining/ kitchen room will be used to prepare meals and will be used for play activities and eating. LPA observed 10 chairs, 2 tables, and toys and play items that are safe, clean, and appropriate for the ages of the children. LPA observed that the kitchen area is secured with child gates at both entrance points. Applicant stated that when a child shows signs of an illness the child will isolated in the bedroom #1. PAGE 1 OF 5

SUPERVISORS NAME: Rita Ramos
LICENSING EVALUATOR NAME: Elicia Calvillo
LICENSING EVALUATOR SIGNATURE:	DATE: 12/17/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/17/2024

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: GEVORGYAN FAMILY CHILD CARE	FACILITY NUMBER: 195700409
	VISIT DATE: 12/17/2024

NARRATIVE

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Bathroom #2 located in bedroom #1 will be used for children. The vanity cabinet has paper products that is made inaccessible with the use of a child safety latch. LPA observed that the bathroom that children will use was safe and sanitary.

The kitchen will be used to prepare snacks and meals Applicant stated they will provide snacks and meals and understands if food is brought in by the parent the container will be labeled with the child’s name. There is telephone service via a cellphone that must remain in the facility during the hours of operation.

The bedrooms and living/dining/kitchen room is equipped with smoke detectors, were tested and are operable. LPA observed a carbon monoxide detector located in the living /dining/ kitchen room. LPA advised that the smoke detectors and carbon monoxide detector should be checked periodically, and batteries should be replaced periodically.

There is a working fire extinguisher, the valve on the 3-A:40BC fire extinguisher indicates fully charged and was serviced on 02/02/2024.

LPA reviewed with Applicant that all homes shall conduct fire and disaster drill at least once every six months and document the date and time of each drill.

There is adequate central heating and ventilation for safety and comfort. LPA did observe a fireplace in the living/ dining/ kitchen room and is made inaccessible to children with dry wall boarding up the opening. There is a fireplace in bedroom #3 and is made inaccessible to children with the use of door lock to the bedroom and a glass enclosure. LPA did not observe any open face heater.

The play yard can be accessed from the living/dining/kitchen and is secured with a door lock, child proof latch, alarm, and camera. The outdoor play area does have a shaded area. The play yard ground is covered with cement and is fenced. LPA observed toys, equipment, and other play items that are safe and appropriate for the ages of the children. LPA did not observe any objects that can pose a danger to children on the outdoor play yard. There is a fence that completely surrounds the play area from the off-limit section of the back yard. Applicant will place a gate by the side of the house to block access to children during play time.
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SUPERVISORS NAME: Rita Ramos
LICENSING EVALUATOR NAME: Elicia Calvillo
LICENSING EVALUATOR SIGNATURE:	DATE: 12/17/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/17/2024

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: GEVORGYAN FAMILY CHILD CARE	FACILITY NUMBER: 195700409
	VISIT DATE: 12/17/2024

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 Applicant states that there are no poisons in the home and understands that storage areas for poisons must be locked with a key or combination lock.

Per Applicant, there are no firearms or other weapons on the premises. LPA did not observe any firearms or other weapons on the premises.

Per Applicant there are no pets on the premises and LPA did not observe any pets on the premises.

LPA did not observe any pools, spas, hot tubs, fish ponds, or similar bodies of water during the inspection.

LPA reviewed with Applicant that children eating may only be in highchairs and that car seats are utilized only for transportation. Applicant was made aware that children shall not be left in parked vehicles. Car seats are used for transportation purposes only and are not used for sleeping children.

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

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.

LPA reviewed with Applicant 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 Applicant has completed training on preventive health practices including Pediatric First Aid and CPR. The Applicant's Pediatric First Aid and CPR expires on 09/2026. There are first aid supplies available. The Applicant does have proof of immunization against influenza, pertussis, and measles. The Applicant does have proof of the Mandated Reporter AB 1207 compliant Child Care Training Certificate.

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SUPERVISORS NAME: Rita Ramos
LICENSING EVALUATOR NAME: Elicia Calvillo
LICENSING EVALUATOR SIGNATURE:	DATE: 12/17/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/17/2024

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: GEVORGYAN FAMILY CHILD CARE	FACILITY NUMBER: 195700409
	VISIT DATE: 12/17/2024

NARRATIVE

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Criminal Record Clearance - Family Child Care Homes Hasmik Gevorgyan, 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.

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. LPAs also informed Applicant 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.

LPA reviewed with Applicant that applicant shall be present in the home and shall ensure that children in care are supervised at all times.

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.

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SUPERVISORS NAME: Rita Ramos
LICENSING EVALUATOR NAME: Elicia Calvillo
LICENSING EVALUATOR SIGNATURE:	DATE: 12/17/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/17/2024

LIC809 (FAS) - (06/04)

Page: 5 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: GEVORGYAN FAMILY CHILD CARE	FACILITY NUMBER: 195700409
	VISIT DATE: 12/17/2024

NARRATIVE

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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, 09/20/2024, 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 following list of corrections needs to be completed prior to licensure approval:

Update Facility Floor Plan
Update Facility Yard Plan

Applicant to correct the above issues by 12/31/2024.

Exit interview conducted and report was reviewed with Hasmik Gevorgyan, Applicant

PAGE 5 OF 5 .

SUPERVISORS NAME: Rita Ramos
LICENSING EVALUATOR NAME: Elicia Calvillo
LICENSING EVALUATOR SIGNATURE:	DATE: 12/17/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/17/2024

LIC809 (FAS) - (06/04)

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