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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197495009
Report Date: 05/04/2022
Date Signed: 05/04/2022 08:10:43 AM

Document Has Been Signed on 05/04/2022 08:10 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:
05/04/2022
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
07:00 AM
MET WITH:Lusik Davtyan/ApplicantTIME COMPLETED:
08:15 AM
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On 05/04/2022 at 7:00 AM Licensing Program Analyst (LPA) Silva Garibyan conducted an announced follow-up Pre-Licensing visit. The purpose of the meeting was to ensure that health, safety and personal rights as required by Title 22 Regulations governing California Family Child Care homes will be met by the Licensee
LPA and applicant toured the facility to ensure the corrections were made as follows:

1) Pool gate shall swing away from the pool, self-close and have a self-latching device located no more than six inches from the top of the gate.

LPA toured the backyard area to ensure that the pool fencing meets the Title 22 requirements. LPA observed the pool gate swings away from the pool, self-close and have a self-latching device located no more than six inches from the top of the gate. The pool fence meets Title 22 regulations.

At this time, all corrections have been verified and the home is ready for licensure. Applicant is reminded that any form of advertisement must include the facility/license number. The license will be approved for a maximum capacity of 14 children. Licensee must adhere to the capacity limitations as specified in the comments sections of the license.


An exit interview was conducted with Lusik Davtyan, applicants and a copy of this report was provided.


SUPERVISORS NAME: Karren Starks
LICENSING EVALUATOR NAME: Silva Garibyan
LICENSING EVALUATOR SIGNATURE: DATE: 05/04/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/04/2022
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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