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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197494843
Report Date: 10/23/2024
Date Signed: 05/29/2025 09:09:32 AM

Document Has Been Signed on 05/29/2025 09:09 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:PETROSYAN FAMILY CHILD CAREFACILITY NUMBER:
197494843
ADMINISTRATOR/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 6DATE:
10/23/2024
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:00 AM
MET WITH:Applicant/Licensee: Natella PetrosyanTIME VISIT/
INSPECTION COMPLETED:
04:00 PM
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On 12/23/24, at 8AM, Licensing Program Analyst (LPA) Joe Katrdzhyan conducted an announced capacity increase and an unannounced Required – 3 Year inspection to the above facility. Upon arrival, LPA disclosed the purpose of the inspection and met with Applicant/Licensee: Natella Petrosyan, who guided the LPA on a tour of the facility. Adults in the home were discussed and all have criminal record clearance. Also present was Dina Petrosian, Licensee’s Assistant. There were 6 day care children present during today’s inspection. Licensee states that there are currently seven (7) children enrolled. The children's roster was reviewed and is current. Per licensee, the facility’s days/hours of operation are Monday - Friday, from 8AM - 6PM. Emergency Disaster Plan, License, and Parents’ Rights were posted at the time of inspection. Disaster drill log was also available during today’s inspection, last disaster drill was conducted on 7/1/24. Family members residing in the home include the Licensee, Licensee's husband, and Licensee's two adult sons.


This is a single story home which consists of 3 bedrooms and 3 bathrooms, play room, living room and a kitchen. The home has an attached garage which was converted to an ADU. The ADU has a separate address (8804 Valjean Ave, North Hills, CA 91343). Licensee provided a copy of the approved building permit (from City of Los Angeles) regarding the ADU. There are currently no individuals residing in the ADU. There is a fireplace located in the off limits living room has been made inaccessible to children in care by a metal screen. Per Licensee, the fireplace is not being used. Areas used by the children include the play room and bathroom 3, which is located inside the playroom. Per Licensee, areas off limits to children include the living room, bedrooms 1 - 3, bathrooms 1 and 2, kitchen and garage/ADU. LPA observed baby gates and doors/screen doors separating areas used by children and off-limit areas. Per licensee, off limit areas are also locked during operating hours.

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NAME OF LICENSING PROGRAM MANAGER: Rita Ramos
NAME OF LICENSING PROGRAM ANALYST: Joe Katrdzhyan
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 10/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/23/2024
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: PETROSYAN FAMILY CHILD CARE
FACILITY NUMBER: 197494843
VISIT DATE: 10/23/2024
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All areas identified on the facility sketch as accessible to children were inspected to ensure that they are clean and orderly with ventilation and heating for the safety of the children. There is a working telephone maintained in the home. LPA observed age appropriate toys, free of loose and sharp parts. LPA observed electrical cover outlets all through the home. Detergents, cleaning compounds, medications, and other items which can pose a danger to children are inaccessible. The Licensee states that there are no poisons in the home. The Licensee does understand that poison must be locked with a key or combination lock. The Licensee was advised that inaccessibility of hazards must be constantly reassessed depending on the children in care. Per licensee, there are no pets and LPA did not observe any pets at the time of visit. Per Licensee, isolation area for sick children is in the corner of the playroom. The main entry door is not used to enter the facility. Parents and children enter from the side gate, which leads to the door to the playroom. Per Licensee, the main door will only be used in the event of an emergency to evacuate the children to the front of the home. The home is equipped with surveillance cameras, inside/outside.

The Children utilize the back yard to play. The back yard is fully fenced. LPA observed a storage shed in the back yard. The shed was observed to be locked. The off limit areas located in the backyard were made inaccessible with the use of a gate/fence and locked. LPA advised Licensee that outdoor supervision is required at all times. LPA observed age appropriate toys free of loose and sharp parts available for the children in the backyard and all trees, shrubs, and plants are maintained. Per Licensee, there are weapons, firearms in the home. Licensee is aware and compliant of Title 22 Regulation Section 102417(g)(4) / Operation of a Family Child Care Home. (Storage areas for poisons, firearms and other dangerous weapons shall be locked. In lieu of locked storage of firearms, the licensee may use trigger locks or remove the firing pin. Firing pins shall be stored and locked separately from firearms. Ammunition shall be stored and locked separately from firearms). Home does not have a swimming pool. LPA observed no bodies of waters.

Per licensee, the facility provides food for children in care (breakfast, AM snack, lunch, PM snack and dinner). Food preparation areas were toured for safety, cleanliness and proper equipment.



The valve on the required 2A 10BC fire extinguisher indicates fully charged. Smoke and carbon monoxide detectors are in operable condition. The First Aid kit was inventoried for necessary supplies. The Licensee has current Pediatric First Aid and CPR. Proof of immunization against influenza, pertussis, and measles was readily available during today’s inspection. The Licensee has also taken the Mandated Reporter Training.
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NAME OF LICENSING PROGRAM MANAGER: Rita Ramos
NAME OF LICENSING PROGRAM ANALYST: Joe Katrdzhyan
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 10/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/23/2024
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: PETROSYAN FAMILY CHILD CARE
FACILITY NUMBER: 197494843
VISIT DATE: 10/23/2024
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— Pediatric First Aid and CPR Card valid until: 01/21/2025
— Mandated Reporter AB1207 Completed: 8/9/2026

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.

Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, 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 up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

Rooms that are off-limits need to be made inaccessible during operating hours. NO smoking, NO infant walkers, NO Johnny jumpers, NO saucer chairs, NO incline sleepers and any other item that falls into that category are permitted in the facility. Effective January 1, 2010, licensees of family child care homes are required to ensure that at least one staff member with current training in pediatric first aid and pediatric CPR is on site at all times when children are present.



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


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NAME OF LICENSING PROGRAM MANAGER: Rita Ramos
NAME OF LICENSING PROGRAM ANALYST: Joe Katrdzhyan
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 10/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/23/2024
LIC809 (FAS) - (06/04)
Page: 3 of 4
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: PETROSYAN FAMILY CHILD CARE
FACILITY NUMBER: 197494843
VISIT DATE: 10/23/2024
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LPA reviewed and issued the LIC 311D - Forms/Records to Keep in Your Family Child Care Home. Mandatory Forms for the children’s files and staff files, requirements for fire drills, earthquake drills and documentation were discussed. Role and responsibilities of being a Mandated Reporter were reviewed. The Licensee was advised how to access forms and Regulations online at www.ccld.ca.gov. Licensee was made aware that it is his/her responsibility to know the regulations as well as anyone who assists in providing care.

AB 1207: Beginning on January 1, 2018, this law requires all licensed providers, applicants, directors and employees to complete training as specified on their mandated reporter duties and to renew their training every two years. Volunteers are encouraged but not required to take the training. Website: http://www.mandatedreporterca.com/

Senate Bill 792: this bill, commencing September 1, 2016, prohibits a person from being employed or volunteering at a child care facility or family day care if he or she has not been immunized against influenza, pertussis and measles. LPA discussed the influenza waiver during the visit.

To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

MyChildCarePlan.org – Centers and Family Child Care Homes Licensee [or facility representative] 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. Megan’s Law - Family Child Care Homes

Per Licensee, there are no Registered Sex Offenders living in the home.

The facility was found in compliance per Title 22 regulations, no deficiencies were issued during today's visit.

A notice of site visit was given and must remain posted for 30 days.

Exit interview was conducted, report was reviewed with the Licensee and copies provided.


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NAME OF LICENSING PROGRAM MANAGER: Rita Ramos
NAME OF LICENSING PROGRAM ANALYST: Joe Katrdzhyan
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 10/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/23/2024
LIC809 (FAS) - (06/04)
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