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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197495048
Report Date: 07/17/2025
Date Signed: 07/17/2025 05:21:29 PM

Document Has Been Signed on 07/17/2025 05:21 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:HAKOBYAN FAMILY CHILD CAREFACILITY NUMBER:
197495048
ADMINISTRATOR/
DIRECTOR:		NINEL HAKOBYANFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(818) 606-9773
CITY:GRANADA HILLSSTATE: CAZIP CODE:
91344
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 7DATE:
07/17/2025
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:30 PM
MET WITH:Ninel Hakobyan, LicenseeTIME VISIT/
INSPECTION COMPLETED:
05:45 PM
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 07/17/2025, Licensing Program Analysts (LPA) Elicia Calvillo conducted an unannounced 3 Year Annual inspection at 16053 Index Street, Granada Hills, CA 91344. LPA arrived at the facility at 02:30 PM, identified self and met with Lusine Hakobyan who was at the facility. Lusine called the Ninel Hakobyan, Licensee, who arrived at the facility approximately 15 minutes later, and guided analyst on a tour of the inside and outside of the facility. There were seven (7) children and two (2) assistants present at arrival. LPA provided Licensee with a copy of the LIC125 Entrance Checklist to help facilitate the inspection. Facility operation hours are Monday to Friday from 8:00AM to 07:00PM.

The family child care home is one story dueling with a combination living/dining room, kitchen, four (4) bedrooms, two (2) bathrooms, and attached garage. There is a front yard that will be used for dropping off children, picking up children, and fenced outdoor play area. There is a fenced backyard behind the house.

The children enter and exit the child care home from the front door.

LPA observed the living /dining room, bedroom #1 and bathroom #1 will be used for child care and accessible to parents and children.

The living/dining room used for indoor play, child activities, music, exercise, and eating. LPA observed toys and play items that are safe clean and appropriate for the ages of the children. Bedroom #1 is used for sleeping and LPA

Page 1 of 5

NAME OF LICENSING PROGRAM MANAGER: Rita Ramos
NAME OF LICENSING PROGRAM ANALYST: Elicia Calvillo
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 07/17/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/17/2025
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 8
California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
Page: 2 of 8
Document Has Been Signed on 07/17/2025 05:21 PM - It Cannot Be Edited


Created By: Elicia Calvillo On 07/17/2025 at 04:18 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: HAKOBYAN FAMILY CHILD CARE
FACILITY NUMBER: 197495048

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/17/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
102370(k)
Criminal Record Clearance
(k) The licensee shall maintain documentation of criminal record clearances or criminal record exemptions of employees, volunteers that require fingerprinting and non-client adults residing in the facility.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on observation, interview, record review, the licensee did not comply with the section cited above in that Lusine Hakobyan did not have a criminal record clearance readily available upon request which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 07/18/2025
Plan of Correction
1
2
3
4
Licensee stated that Lusine Hakobyan will obtain a criminal record clearance or transfer their criminal record clearance by the plan of correction due date 07/18/2025 and email LPA when it has been completed.
Type A
Section Cited
CCR
102391(d)
Inspection Authority of the Department
(d) The licensee shall permit the Department to inspect, audit, and copy children's records or other family child care home records upon demand during normal business hours. Records may be removed if necessary for copying.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on observation, interview, record review, the licensee did not comply with the section cited above in 14 of 14 children enrolled at the facility did not have a childrens record file readily available for the departent to inspect which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 07/18/2025
Plan of Correction
1
2
3
4
Licensee stated they will have all children's records completed by the plan of correction due date 07/18/2025 and will email LPA when they are completed.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Rita Ramos
NAME OF LICENSING PROGRAM MANAGER:
Elicia Calvillo
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 07/17/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/17/2025


LIC809 (FAS) - (06/04)
Page: 3 of 8
Document Has Been Signed on 07/17/2025 05:21 PM - It Cannot Be Edited


Created By: Elicia Calvillo On 07/17/2025 at 04:18 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: HAKOBYAN FAMILY CHILD CARE
FACILITY NUMBER: 197495048

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/17/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
102416.1(d)
Personnel Records
(d) All personnel records shall be maintained at the child care home and shall be available to the licensing agency for review.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on observation, interview, and record review, the licensee did not comply with the section cited above in 2 of 2 personnel records were not readily availabe upon request which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 07/18/2025
Plan of Correction
1
2
3
4
Licensee stated that they will complete the personnel records by the plan of correction due date 07/18/2025 and notify LPA when they are complete.
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.
Rita Ramos
NAME OF LICENSING PROGRAM MANAGER:
Elicia Calvillo
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 07/17/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/17/2025


LIC809 (FAS) - (06/04)
Page: 4 of 8
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: HAKOBYAN FAMILY CHILD CARE
FACILITY NUMBER: 197495048
VISIT DATE: 07/17/2025
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
26
27
28
29
30
31
32
observed a combination of eight (8) cots and pack n’ plays and bed linens that are provided by the parents. Licensee stated that they have four (4) additional cots and pack n’ plays in storage. LPA observed eleven (11) chairs, two (2) tables, and 3 highchairs that were safe, clean, and appropriate for the ages of the children.

LPA observed the children will have access to bathroom #1 near bedroom #1. The vanity cabinet holds paper products, personal items, no hazards were observed. LPA observed that the bathroom that children will use was safe and sanitary.

The outdoor play area is located on the front yard of the house, is fenced and there are no hazards to children present. The children have access to a climbing structure with a slide and there is artificial grass surrounding and underneath to absorb falls. LPA observed there are toys and play equipment that are free of sharp pointed parts, in good repair, and appropriate for the ages of the children in care.

Licensee stated that when a child shows signs of an illness the child will isolated in bedroom #2 away from the other children. Licensee stated that they will update their facility sketch -floor plan and yard.

The kitchen, bedroom #2, bedroom #3, bedroom#4, and bathroom #2 are off-limits to parents and children and made inaccessible by use of door locks.

There is a telephone service via a cellphone. LPA advised Licensee that the cellphone must remain in the child care home during the hours of operation.

There is a combination smoke detector and carbon monoxide detector in the combination living/dining room; and was tested and not operable. There is a working fire extinguisher, the valve on the required 2A:10BC fire extinguisher indicates fully charged and Licensee was unable to confirm the last purchase or service date. LPA did observe fireplace or open face heaters. There is adequate heating, lighting, and ventilation for safety and comfort.

LPA did not observe any pools, spas, hot tubs, fish ponds, or similar bodies of water during the inspection on the property.

Page 2 of 5
NAME OF LICENSING PROGRAM MANAGER: Rita Ramos
NAME OF LICENSING PROGRAM ANALYST: Elicia Calvillo
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 07/17/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/17/2025
LIC809 (FAS) - (06/04)
Page: 5 of 8
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: HAKOBYAN FAMILY CHILD CARE
FACILITY NUMBER: 197495048
VISIT DATE: 07/17/2025
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
26
27
28
29
30
31
32
Per Licensee, there are no firearms or ammunition or other weapons on the premises. LPA did not observe any firearms or other weapons on the premises. Per Licensee, there are no poisons in the home and LPA did not observe any during the inspection. Detergents, cleaning compounds, medication and other hazardous items are made inaccessible with the use of a safety gate.

Licensee stated there are no pets on the premises. LPA did not observe any pets on the premises.

There are currently no infants in care under the age of 12 months. LPA advised that infants are checked on every 15 minutes and the time of each 15-minute check was documented with child’s name and date. A LIC 9227 Individual Infant Sleeping Plan for each infant up to 12 months of age and reference Provider Information Notice (PIN) 20-24 CCP.

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

Licensee was reminded that children in care are to be supervised at all times and made aware that children shall not be left in parked vehicles. Car seats are used for transportation purposes only and are not used for sleeping children.

Capacity as specified on the license is being maintained.

LPA was not able to review a sample of children’s files. Licensee stated they do not have any children’s files.

LPA was not able to review the personnel files. Licensee stated they do not have any personnel files.
Page 3 of 5
NAME OF LICENSING PROGRAM MANAGER: Rita Ramos
NAME OF LICENSING PROGRAM ANALYST: Elicia Calvillo
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 07/17/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/17/2025
LIC809 (FAS) - (06/04)
Page: 6 of 8
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: HAKOBYAN FAMILY CHILD CARE
FACILITY NUMBER: 197495048
VISIT DATE: 07/17/2025
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
26
27
28
29
30
31
32
An emergency fire/disaster drill has been completed within the last 6 months on 04/16/2025 and the documentation of the fire/disaster drill was not readily available upon request. Licensee’s Mandated Reporter Training was not readily available for inspection. Licensee’s pediatric CPR/First Aid was not readily available upon request.

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 or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated. LPA observed that Lusine Hakobyan at the facility without a Criminal Record Clearance. Per Licensee, Lusine Hakobyan comes to the facility when the Licensee has birthday parties or to decorate the facility. When LPA arrived at the facility it appeared that Lusine Hakobyan was assisting with the supervision of the children. Licensee stated that Lusine Hakobyan has been present at the facility three (3) other times.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: https://www.ada.gov/resources/child-care-centers/.

During the exit interview, the Licensee, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California

Page 4 of 5

NAME OF LICENSING PROGRAM MANAGER: Rita Ramos
NAME OF LICENSING PROGRAM ANALYST: Elicia Calvillo
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 07/17/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/17/2025
LIC809 (FAS) - (06/04)
Page: 7 of 8
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: HAKOBYAN FAMILY CHILD CARE
FACILITY NUMBER: 197495048
VISIT DATE: 07/17/2025
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
26
27
28
29
30
31
32
To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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/inspection-process.

During today’s visit, per Title 22, Division 12, Chapter 3, of the California Code of Regulations, there was three (3) Type A citations issued for section 102370(k) Criminal Record Clearance with a $300.00 Civil Penalty and a plan of correction due date of 07/18/2025, for section 102391(d) Inspection Authority of the Department with a plan of correction due date of 07/18/2025, and for section 102416.1(d) Personnel Records with a plan or correction due date of 07/18/2025.

LPA informed licensee Ninel Hakobyan that this report dated 07/17/2025 document(s) three (3) Type A citation(s) which shall be posted for 30 consecutive days as there is/are immediate risk(s) to the health, safety, or personal rights of children in care.

Also, LPA informed the licensee to provide a copy of this licensing report dated 07/17/2025 that documents any Type A citation(s) to parents/guardians of all children currently enrolled by the next business day or the next day the 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 the child's file for verification.

A Notice of Site Visit was given and must remain posted for 30 days during the hours of operation after each site visit by a licensing representative. Failure to comply with posting requirement will result in an immediate civil penalty of $100.00.

Exit interview was conducted with Ninel Hakobyan, Licensee including, but not limited to Provider Rights, Appeal Procedures and Agencies Consultative Role.

Page 5 of 5
NAME OF LICENSING PROGRAM MANAGER: Rita Ramos
NAME OF LICENSING PROGRAM ANALYST: Elicia Calvillo
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 07/17/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/17/2025
LIC809 (FAS) - (06/04)
Page: 8 of 8