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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197495009
Report Date: 04/14/2022
Date Signed: 04/14/2022 07:55:04 AM

Document Has Been Signed on 04/14/2022 07:55 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
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:DAVTYAN FAMILY CHILD CAREFACILITY NUMBER:
197495009
ADMINISTRATOR:LUSIK DAVTYANFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(323) 229-6434
CITY:VAN NUYSSTATE: CAZIP CODE:
91405
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 0DATE:
04/14/2022
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
07:00 AM
MET WITH:Lusik Davtyan/ApplicantTIME COMPLETED:
08:00 AM
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Licensing Program Analyst (LPA) Silva Garibyan conducted a follow-up pre-licensing visit. LPA and applicant toured the facility inside and outside on 03/14/2022 at 7:00 am to ensure the corrections were made as follows:

1) Placement of pool fence

LPA toured the backyard area to ensure that the pool fencing meets the Title 22 requirements. LPA observed that the pool gate was not self-closing or self-latching.

Applicant was informed that the following is pending licensure and needs to be corrected within 30 days from the date of this report

The gate shall be self-closing and latching, and swing open away from the body of water. The latching mechanism shall be no more than six inches below the top of the gate.



A copy of this report was issued to and explained to the applicant.
SUPERVISORS NAME: Karren Starks
LICENSING EVALUATOR NAME: Silva Garibyan
LICENSING EVALUATOR SIGNATURE: DATE: 04/14/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/14/2022
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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