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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197495153
Report Date: 07/12/2022
Date Signed: 07/12/2022 11:53:11 AM

Document Has Been Signed on 07/12/2022 11:53 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:KHACHATRYAN FAMILY CHILD CAREFACILITY NUMBER:
197495153
ADMINISTRATOR:GOHAR KHACHATRYANFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(909) 242-4633
CITY:GRANADA HILLSSTATE: CAZIP CODE:
91344
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 0DATE:
07/12/2022
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
09:50 AM
MET WITH:GOHAR KHACHATRYANTIME COMPLETED:
12:05 PM
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On 7/12/2022, Licensing Program Analyst (LPA) Loyce Phillips conducted an announced Pre-Licensing inspection with Licensee, Gohar Khachatryan. This inspection is due to an application received for a relocation of a large family childcare license. Licensee guided LPA on a tour of the facility and intends to operate Monday through Friday from 8:00am to 6:30pm.

Licensee has child-care insurance. The areas identified on the facility sketch were inspected. This is a 5 bedroom, 3 bathroom home with living room, kitchen, dining area, and converted attached garage. Licensee resides in the home with spouse and 1 adult son. Licensee intends to provide breakfast, lunch, dinner and am/pm snacks to children.

Areas that are accessible to children are as follows: Converted attached garage (day care room), bedroom #2, #3, bathroom #2, living room, kitchen, dining area and backyard. Licensee is aware that children will only do daily activities in the converted garage. Eating, sleeping and toileting are conducted in the main house. Off-limit areas to children: bedroom #1, #4, #5, bathroom #1, #3, shed located in the back yard and left side of the home. All off-limit bedrooms, bathrooms, shed and left side of the home are inaccessible by key door locks.

The home was inspected inside and out for safety, comfort, cleanliness, telephone service, heating and ventilation, poisons, detergents/cleaning compounds, medication and hazardous items that can pose a danger to children are inaccessible. LPA observed age appropriate safe toys inside and outside. Licensee advised; children will nap on cots. Licensee has a carbon and smoke detector that was tested and operating. Medications are stored in an Bedroom #1 inaccessible to children. Knives were observed in an upper kitchen cabinet inaccessible to children. Cleaning products are kept in the laundry area located outside to the left of the home. This area is inaccessible to children

LPA reviewed with Licensee the LIC 311D, Forms/Records To Keep In Your Family Child Care Homes, children’s forms/records, facility forms/records, and information to be posted.

SUPERVISORS NAME: Peter Flores
LICENSING EVALUATOR NAME: Loyce Phillips
LICENSING EVALUATOR SIGNATURE: DATE: 07/12/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/12/2022
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 2
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: KHACHATRYAN FAMILY CHILD CARE
FACILITY NUMBER: 197495153
VISIT DATE: 07/12/2022
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Licensee was reminded that all adults 18 and over living in the home, persons who provide care and supervision to children, and staff who have contact with children, including employees and volunteers, 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 up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep web page at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resources. 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.

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: http://www.ada.gov/childqanda.htm

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletter and other important information communication platform.

To receive important licensed related information to licensed facilities, visit the CCLD Important Information website at

https://www.cd.ss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

Based on today's inspection, Licensee is approved for a License pending managers approval.

Exit interview conducted and report was reviewed Licensee, Gohar Khachatryan.

SUPERVISORS NAME: Peter Flores
LICENSING EVALUATOR NAME: Loyce Phillips
LICENSING EVALUATOR SIGNATURE:

DATE: 07/12/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/12/2022
LIC809 (FAS) - (06/04)
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