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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197494927
Report Date: 06/06/2023
Date Signed: 06/06/2023 01:22:29 PM

Document Has Been Signed on 06/06/2023 01:22 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 CAREFACILITY NUMBER:
197494927
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 7CENSUS: 5DATE:
06/06/2023
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
12:30 PM
MET WITH:Syuzanna GalstyanTIME COMPLETED:
01:35 PM
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On 06/06/2023, Licensing Program Analysts (LPAs) Maria Rendon and Deborah Lowe arrived at the Galstyan Family Child Care Home and met with Syuzanna Galstyan. The purpose of the visit was a case management inspection at the facility for the purpose of inspecting the facility due to Licensee submitting an application for a capacity increase. There were 05 children present during this inspection.

This is a capacity increase application for a large family child care license with up to14 children ages 0-12 years old, Monday through Friday 6:30 am- 5:00am. Fire Clearance STD 850 was GRANTED on 2/6/2023.

Annual visit was conducted during visit on 6/6/23.

The family child care home is a 4 bedroom, 2 bathroom, living room, dining room, kitchen and laundry room with 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. LPA requested licensee to provided an updated facility sketch documenting kitchen as Off Limits and label child play areas.

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

pg 1 of 2

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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A capacity regulations flyer was given licensee to show how many children and their ages can be cared for at once. LPAs provided licensee with information on infant safe sleep regulations along with safe sleep environment flyers, safe sleep log, safe sleep regulation and frequently asked questions. LPA's also provided licensee with LIC311D -forms/records to keep at your family child care home and the Family Child Care Home Entrance Checklist, to ensure files are maintained up to date. LPA's reminded licensee to ensure the fire extinguisher is serviced yearly and has either purchase receipt or service tag readily available.

LPA advised per child care regulation, 102416.5(e) Staffing Ratio and Capacity (e) If no assistant provider is present at a Large Family Child Care Home, then the licensee shall comply with the capacity requirements for a Small Family Child Care Home as specified in subsections (b) and (c).

Backyard was inspected and LPAs observed a metal gas meter located on the outdoor area on the westside of the home. LPAs advised to make the area where the gas meter is located inaccessible to children.

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

An exit interview was conducted with the above items discussed and a copy of appeal rights and this report was provided to the Licensee Syuzanna Galstyan. Final license determination will be made upon review by the Licensing Program Manager and correction of the above issues.

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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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