<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197495048
Report Date: 04/14/2022
Date Signed: 04/14/2022 10:29:07 AM

Document Has Been Signed on 04/14/2022 10:29 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:HAKOBYAN FAMILY CHILD CAREFACILITY NUMBER:
197495048
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 0DATE:
04/14/2022
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:NINEL HAKOBYANTIME COMPLETED:
10:40 AM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
On 4/14/2022 Licensing Program Analyst (LPA) Loyce Phillips conducted an announced Pre Licensing inspection with Applicant, Ninel Hakobyan. Today's inspection is a follow up to the Pre-Licensing inspection conducted on 3/24/2022.

During the pre-licensing inspection conducted on 3/24/2022 the following corrections were required:
- All bedrooms made inaccessible
- Bathroom #1 made inaccessible
- Storage area made inaccessible
- Kitchen made inaccessible
- Complete Parent Board with required posted documents
- Replace carbon monoxide

During today's inspection the following corrections were observed and completed:


- All bedrooms made inaccessible by child safety door knobs.
- Bathroom #1 made inaccessible by child safety door knob.
- Storage area made inaccessible by pad lock.
- Kitchen made inaccessible by safety gate.
- Parent Board completed with required documents.
- Carbon monoxide detector operable.

Applicant is approved for a license pending managers approval.

An exit interview was conducted and a copy of this report was provided to the Applicant, Ninel Hakobyan.

SUPERVISORS NAME: Peter Flores
LICENSING EVALUATOR NAME: Loyce Phillips
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)
Page: 1 of 1