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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197417778
Report Date: 12/21/2022
Date Signed: 12/21/2022 03:41:01 PM

Document Has Been Signed on 12/21/2022 03:41 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:KARAPETIAN FAMILY CHILD CAREFACILITY NUMBER:
197417778
ADMINISTRATOR:KARAPETIAN, NONNAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(818) 986-1787
CITY:SHERMAN OAKSSTATE: CAZIP CODE:
91403
CAPACITY: 12TOTAL ENROLLED CHILDREN: 8CENSUS: 8DATE:
12/21/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:30 PM
MET WITH:KARAPETIAN, NONNA- LicenseeTIME COMPLETED:
04:00 PM
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On 12/21/2022 Licensing Program Analyst (LPA), Suzette Ornelas conducted an unannounced Annual Required Inspection and was met by Licensee, KARAPETIAN, NONNA. Also present was Licensees Assistant. Days and hours of operation are Monday through Friday 7:30am-5:30pm.

LPA toured the home inside and outside and a census was taken. LPA observed 6 children and 2 infants in care. Current facility sketch reviewed and all areas identified on the facility sketch were inspected. Licensee's home is a one story dwelling with 3 bedrooms and, 2 bathrooms. Children in care have access to the bathroom located in the hallway. Child care is provided mainly in the living room area and the bedroom at the end of the hallway next to the on-limits bathroom. Children eat in the living room area. All other rooms are off-limits and made inaccessible by use of supervision, gates and closed doors. Children have access to the back yard for activities. The Fire Extinguishers (2A-10-BC) is mounted on the wall in the laundry room. There is a working smoke/carbon monoxide detector located in every room. The required carbon monoxide detectors and smoke detectors are in operable condition.

The home was inspected inside and out for safety, comfort, cleanliness, telephone service, heating and ventilation, inaccessibility to poisons, detergents, cleaning compounds, medicines, and hazardous items that can pose a danger to children. The First Aid kit was observed and complete. Per LIS the facility annual fees are current. The facility roster was observed, and current. There are age appropriate toys and napping equipment on the premises. Licensee has posted as required the License, and all other required postings in a visible location.



There are no firearms or ammunition on the premises. There is no swimming pool or other bodies of water on the premises. Fireplace located in the living room is covered and made inaccessible to children in care.
SUPERVISORS NAME: Lisa Rios
LICENSING EVALUATOR NAME: Suzette Ornelas
LICENSING EVALUATOR SIGNATURE: DATE: 12/21/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/21/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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Document Has Been Signed on 12/21/2022 03:41 PM - It Cannot Be Edited


Created By: Suzette Ornelas On 12/21/2022 at 02:53 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: KARAPETIAN FAMILY CHILD CARE
FACILITY NUMBER: 197417778

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/21/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1596.8662(b)(1)
Administration of Child Day Care Licensing
(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation interview record review, the licensee did not comply with the section cited above in 2 staff members did not have current mandated reporter training certificate which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 01/11/2023
Plan of Correction
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Licensee will provide proof of completion to LPA via email.
Type B
Section Cited
CCR
102418(a)
Immunizations
(a) Prior to admission to a family day care home, children shall be immunized against diseases as required by the California Code of Regulations, Title 17, beginning with Section 6000.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation interview record review, the licensee did not comply with the section cited above in 3 children did not have immunization records on file which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 01/11/2023
Plan of Correction
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Licensee will provide proof to LPA via email.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Lisa Rios
LICENSING EVALUATOR NAME:Suzette Ornelas
LICENSING EVALUATOR SIGNATURE:
DATE: 12/21/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/21/2022


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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: KARAPETIAN FAMILY CHILD CARE
FACILITY NUMBER: 197417778
VISIT DATE: 12/21/2022
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There are currently 2 infants in care. LPA discussed Safe Sleep Regulations with licensee and provided a copy of the Infant Safe Sleep Regulation, a sample of an infant safe sleep log, a copy of the LIC 9227, and Frequently Asked Questions regarding Infant Safe Sleep packet. Licensee immediately began documentation for 2 infants. Licensee will ensure LIC9227 is obtained and kept for each infant under 12 months. Licensee ensures that children in care are supervised at all times and is aware children shall not be left in parked vehicles. Car seats are used for transportation purposes only and are not used for sleeping children. The outdoor play area in the backyard is fenced and there are no hazards to children present. LPA discussed the importance of ensuring that equipment is regularly inspected, dusted off as needed and removed if broken.

Capacity as specified on the license is being maintained. LPA reviewed 5 children's records and observed records were incomplete. LPA provided Licensee with copies of the CDPH 286 (blue form) and information on ensuring form in filled out by licensee and kept in children’s file moving forward. Licensee will obtain immunization records for 3 children in care and provide proof to LPA via email. An emergency fire/disaster drill has not been completed and documented within the last 6 months. LPA provided licensee with a copy of an Emergency Drill Log and information ensuring documentation is kept readily available moving forward. Licensee and Assistants pediatric CPR/First Aid is current. Licensee and Assistants Mandated Reporter Training is not current. LPA provided information regarding the Mandated Reported Training regulation and the requirement to complete every two years. Licensee will provide proof of completion to LPA via email. All adults who reside or work in the home have a criminal record clearance or exemption. There are no excluded individuals present at this home.

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 and Licensee discussed the Community Care Licensing website www.ccld.ca.gov which will provide access to Provider Information Notices (PINs), Quarterly Updates, COVID-19 Information and Resources, Mandated Reporter Training, Safe Sleep in Child Care, Lead Poisoning Facts, Forms and Regulations.
SUPERVISORS NAME: Lisa Rios
LICENSING EVALUATOR NAME: Suzette Ornelas
LICENSING EVALUATOR SIGNATURE:

DATE: 12/21/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/21/2022
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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: KARAPETIAN FAMILY CHILD CARE
FACILITY NUMBER: 197417778
VISIT DATE: 12/21/2022
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LPA and Licensee discussed the Community Care Licensing website www.ccld.ca.gov which will provide access to Provider Information Notices (PINs), Quarterly Updates, COVID-19 Information and Resources, Mandated Reporter Training, Safe Sleep in Child Care, Lead Poisoning Facts, Forms and Regulations.

Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, 2 type B deficiencies are being cited.

Facility Administration - Type B: 1596.8662(b)(1)
Records - Type B: 102418(a)

This report shall be made available to the public upon request. LIC 9213 Notice of Site Visit is provided and required to be posted for 30 days.

suzette.ornelas@dss.ca.gov
SUPERVISORS NAME: Lisa Rios
LICENSING EVALUATOR NAME: Suzette Ornelas
LICENSING EVALUATOR SIGNATURE:

DATE: 12/21/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/21/2022
LIC809 (FAS) - (06/04)
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