197494927-6-6-2023-58-CC-MREN-CSJRQ8-20230606131307

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197494927
Report Date: 06/06/2023
Date Signed: 06/06/2023 01:13:24 PM

Document Has Been Signed on 06/06/2023 01:13 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:	GALSTYAN FAMILY CHILD CARE		FACILITY NUMBER:	197494927
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 7	CENSUS: 5	DATE:	06/06/2023
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	08:29 AM
MET WITH:	Syuzanna Galstyan		TIME COMPLETED:	12:29 PM

NARRATIVE

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On 06/06/23 Licensing Program Analysts (LPAs) Maria Rendon and Deborah Lowe, met with Licensee, Syuzanna Galstyan. The purpose of this visit was an unannounced Annual Required Inspection at Galstyan Family Child Care home located 8308 Wilbur Ave, to ensure that health, safety and personal rights as requires by Title 22 and Health and Safety Regulations governing California Child Care Homes are met. Currently living in the home is the licensee, husband, and 2 minor children. Days and hours of operation are Monday-Friday 6:30am-5:00am. Facility hours include overnight care and per licensee currently there are no children enrolled in overnight care. There were 05 children present during this inspection.

The family child care home is a 4 bedroom, 2 bathroom, living room, dining room, kitchen and laundry room with an attached garage. LPA toured the home inside and outside and a census was taken.

Current facility sketch reviewed, and Licensee confirmed that 1 bedroom, dining room, living room, and 1 bathroom are used for providing care and are accessible to children. All other rooms, 3 bedrooms, the kitchen, 1 bathroom, laundry room, and garage, are off-limits and made inaccessible by use of doors and child proof door handles. The kitchen is inaccessible by the use of a child gate.

Areas that will be used by the children were inspected for safety, comfort, cleanliness, ventilation, and heating.

LPAs observed detergents, cleaning compounds, shampoo, conditioner, sharp objects and hazardous items that can pose a danger to children were accessible in the bathroom designated for children. Clorox Cleaning bottle was observed on the floor between the cabinet and toilet. Shampoo, conditioner, and razors were observed in a lower shelf in the shower. Cabinet under sink was observed without a latch accessible to children and in the cabinet LPAs observed razors and shaving cream. Pictures were taken. LPAs advised per child care regulation 102417(g)(4) Operation of A Family Child Care Home (4) Poisons, detergents, cleaning compounds, medicines, firearms and other items which could pose a danger if readily available to children shall be stored where they are inaccessible to children. Licensee will be cited a Type A. During the visit licensee made Clorox cleaning bottle, razors, and shaving cream made the cabinet inaccessible to children with the use of child proof latch. Pg 1 of 4

SUPERVISORS NAME: Lisa Rios
LICENSING EVALUATOR NAME: Maria Rendon
LICENSING EVALUATOR SIGNATURE:	DATE: 06/06/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/06/2023

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: GALSTYAN FAMILY CHILD CARE	FACILITY NUMBER: 197494927
	VISIT DATE: 06/06/2023

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Shampoo, conditioner, and razors were removed from the shower and taken to the off limits master bathroom. The applicant was advice that any poisons must be locked.
LPAs observed a fireplace located in the living room is made inaccessible by a metal and glass enclosure and will not be in use during daycare hours. LPAs observed two fire extinguishers in the kitchen. One was observed to be a 2-A:10-B:C and the second was observed to be 10-B:C. LPA advised that 2-A:10-B:C is the appropriate size for a childcare family home. LPAs observed and tested 2 smoke detectors and a combo smoke detector/carbon monoxide detector in the play area near the kitchen, one smoke detector in the hallway between the bedrooms and one in the bedroom accessible to children. There was adequate heating and ventilation for safety and comfort.

LPAs observed 8 cots and one play yard for napping. There is currently one infant in care who was observed to be developmental and age appropriate to sleep on a cot. LPA discussed Safe Sleep Regulations with licensee. There is one play yard for each infant in care and play yard is kept free from all loose articles and objects while infant is sleeping, and there are no objects hanging above or attached to the play yard. Infant is not swaddled while in care. Provider physically checks on sleeping infants every fifteen minutes and documents any signs of distress which includes but is not limited to flushed skin color, increase in body temperature, restlessness, and labored breathing. Infants can be visually observed through an open door if sleeping in a separate room. Currently no enrolled children are under 12 months. LPAs reviewed Individual Infant Sleeping Plan and advised to be completed and filed in the child’s file for each infant up to 12 months of age. Infants up to 12 months of age are placed on their backs for sleeping.

Licensee states that she will provide food for children in care. If food is not provided and food is brought from the children’s homes, containers shall be labeled with child’s name and properly stored or refrigerated.

There is no swimming pool or other bodies of water on the premises.

Per licensee there are no firearms or ammunition on the premises.

Licensee was reminded that children in care are supervised at all times. 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. The outdoor area was observed to have a storage unit that is off limits to children as is inaccessible to children by the use of a locked metal gate.

Pg 2 of 4

SUPERVISORS NAME: Lisa Rios
LICENSING EVALUATOR NAME: Maria Rendon
LICENSING EVALUATOR SIGNATURE:	DATE: 06/06/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/06/2023

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: GALSTYAN FAMILY CHILD CARE	FACILITY NUMBER: 197494927
	VISIT DATE: 06/06/2023

NARRATIVE

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Capacity as specified on the license is being maintained.

LPAs observed the following required postings: current facility license, LIC610A Emergency Disaster Plan, and PUB 394 Notification of Parents’ Rights Poster. LPAs reviewed facility’s current LIC 9040 Child Care Roster. LPAs reviewed a sample of children’s file and found children’s file in compliance with LIC700 Identification and Emergency information, LIC627 Consent for Emergency Medical Treatment, and LIC995 Notification of Parent’s Rights, and immunization records. An emergency fire/disaster drill has been completed and documented within the last 6 months. Licensee’s Mandated Reporter Training was completed on 12/21/22. Licensee’s pediatric CPR/First Aid expires on 03/24/24. A review of records indicates that all employees and/or volunteers have immunization records on file for influenza, pertussis and measles, CPR and Mandated Reporter certificate on file.

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.

Licensee 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, 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.

Incidental Medical Services (IMS) are 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 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

pg 3 of 4

SUPERVISORS NAME: Lisa Rios
LICENSING EVALUATOR NAME: Maria Rendon
LICENSING EVALUATOR SIGNATURE:	DATE: 06/06/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/06/2023

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: GALSTYAN FAMILY CHILD CARE	FACILITY NUMBER: 197494927
	VISIT DATE: 06/06/2023

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

To improve the quality and value of the new inspection process, a survey will 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 tools, please send them by email 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/process.

Per Title 22, Division 12, Chapter 1, of the California Code of Regulations, the following deficiency is being cited: (see next page, 809 D) Licensee was provided a copy of appeal rights.

LPAs Maria Rendon and Deborah Lowe informed licensee Syuzanna Galstyan that this report dated 6/6/23 document one Type A citation which shall be posted for 30 consecutive days as there is/ are immediate risk to the health, safety, or personal rights of children in care.

Also, LPAs Maria Rendon and Deborah Lowe informed the licensee Syuzanna Galstyan to provide a copy of this licensing report dated 6/6/23 that documents any Type A citation(s) to parents/guardian of all children currently enrolled by the next business day or the next day children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of licensing report (LIC 9224), or other written statement, must be placed in child’s file for verification.

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

Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

An exit interview was conducted, a copy of this report and appeal rights were provided and reviewed with Licensee Syuzanna Galstyan.

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SUPERVISORS NAME: Lisa Rios
LICENSING EVALUATOR NAME: Maria Rendon
LICENSING EVALUATOR SIGNATURE:	DATE: 06/06/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/06/2023

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 06/06/2023 01:13 PM - It Cannot Be Edited

Created By: Maria Rendon On 06/06/2023 at 12:06 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: GALSTYAN FAMILY CHILD CARE	FACILITY NUMBER: 197494927
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 06/06/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type A

Section Cited

CCR

102417(g)(4)

Operation of A Family Child Care Home

(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (4) Poisons, detergents, cleaning compounds, medicines, firearms and other items which could pose a danger if readily available to children shall be stored where they are inaccessible to children. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation and interview, the licensee did not comply with the section cited above in LPAs observed clorox cleaning compounds, shampoo, conditioner, sharp objects and hazardous items that can pose a danger to children were accessible in the bathroom designated for children which poses an immediate health, safety or personal rights risk to persons in care.
	POC Due Date: 06/06/2023
	Plan of Correction
1 2 3 4	During visit licensee installed child proof latches on bathroom cabintes and shampoo, conditioner, and razors were removed from the shower and taken to the off limits master bathroom.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

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:

Maria Rendon

LICENSING EVALUATOR SIGNATURE:

DATE: 06/06/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/06/2023

LIC809 (FAS) - (06/04)

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