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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197495155
Report Date: 04/15/2024
Date Signed: 04/17/2024 08:39:52 AM

Document Has Been Signed on 04/17/2024 08:39 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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:AVETISYAN FAMILY CHILD CAREFACILITY NUMBER:
197495155
ADMINISTRATOR/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 4DATE:
04/15/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:30 AM
MET WITH:Licensee / Azatuhi AvetisyanTIME VISIT/
INSPECTION COMPLETED:
04:00 PM
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On 4/15/24, at 9:30AM, Licensing Program Analyst (LPA) Joe Katrdzhyan conducted an announced capacity increase and an unannounced Annual Random inspection. Upon arrival, LPA disclosed the purpose of the inspection and met with Licensee, Azatuhi Avetisyan who guided LPA on a tour of the facility. This is a capacity increase application for a large family child care license with up to 14 children. Adults in the home were discussed and all have criminal record clearance. Also present was Alyona Khachatryan, Licensee’s Assistant. There were 4 day care children present during today’s inspection, of which one is an infant. (three out of the four children observed were the Licensees children) Licensee states that there are currently 5 children enrolled. The children's roster was reviewed and is current. Per licensee, the facility’s hours of operation are 8AM - 11:59PM, Monday - Friday. Emergency Disaster Plan, License, and Parents’ Rights were posted at the time of inspection. Disaster drill log was also available during today’s inspection, last disaster drill was conducted on 2/25/24.

This is a single story home which consists of three (3) bedrooms and two and a half (2 1/2) bathrooms, kitchen, living room, dining room, laundry room, patio, pool and a two car attached garage. There is a fireplace in the home that is barricaded by a black screen, making it inaccessible to children. Areas used by children include the living room, dining room, bedrooms 1 and 2, main bathroom (bathroom 2) located in the hallway and the front yard. Per Licensee, areas off limits to children include the kitchen, bedroom 3 (master), bathrooms 1 and 3, laundry room, garage, back patio and pool. LPA observed a baby gate separating the kitchen area, making it inaccessible to children. Per licensee, off limit areas are locked by door locks and child safety mechanisms, during operating hours. LPA observed a pool table, refrigerator, couch, table with 6 chairs and a trampoline located in the back patio area. There is a swimming pool on the premises. The swimming pool has a black mesh gate all around. The gate swings away from the pool. There is a sliding door located in the living room which leads to the back patio area and also to the pool. The sliding door is equipped with double locks, preventing children from accessing the patio / pool area.
SUPERVISORS NAME: Rita Ramos
LICENSING EVALUATOR NAME: Joe Katrdzhyan
LICENSING EVALUATOR SIGNATURE: DATE: 04/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/15/2024
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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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: AVETISYAN FAMILY CHILD CARE
FACILITY NUMBER: 197495155
VISIT DATE: 04/15/2024
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All areas identified on the facility sketch as accessible to children were inspected to ensure that they are clean and orderly with ventilation and heating for the safety of the children. There is a working telephone maintained in the home. LPA observed age appropriate toys, free of loose and sharp parts. LPA observed electrical cover outlets all through the home. Detergents, cleaning compounds, medications, and other items which can pose a danger to children are inaccessible. The Licensee states that there are no poisons in the home. The Licensee does understand that poison must be locked with a key or combination lock. The Licensee was advised that inaccessibility of hazards must be constantly reassessed depending on the children in care. Per licensee, there is a pet dog which is kept outside, behind the patio area making the dog inaccessible to children. LPA observed the dog at the time of visit. Per Licensee, isolation area for sick children is in bedroom 2.

Per licensee, the children will have access to the front yard area. LPA observed the front yard has artificial grass and adequate perimeter fencing through-out the yard. LPA advised Licensee that outdoor supervision is required at all times. Per Licensee, there are no weapons, firearms in the home.

Per licensee, the facility provides food for children in care (breakfast, lunch, dinner and snacks). Food preparation areas were toured for safety, cleanliness and proper equipment.

LPA observed four (4) fully charged 2A 10BC fire extinguishers. Smoke and carbon monoxide detectors were tested and are in operable condition. Per Licensee, the First Aid kit is kept in the hallway closet. The First Aid kit was inventoried for necessary supplies. The Licensee has current Pediatric First Aid and CPR. Proof of immunization against influenza, pertussis, and measles was readily available during today’s inspection. The Licensee has also taken the Mandated Reporter Training.

— Pediatric First Aid and CPR Card valid until: 04/2026
— Mandated Reporter AB1207 Completed: 04/2026
SUPERVISORS NAME: Rita Ramos
LICENSING EVALUATOR NAME: Joe Katrdzhyan
LICENSING EVALUATOR SIGNATURE:

DATE: 04/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/15/2024
LIC809 (FAS) - (06/04)
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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: AVETISYAN FAMILY CHILD CARE
FACILITY NUMBER: 197495155
VISIT DATE: 04/15/2024
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Incidental Medical Services (IMS) are not currently being provided. Licensee is aware that an IMS plan is required to be submitted to the licensing office if they provide any of these services. Information regarding Americans with Disability Act (ADA) can be obtained by contacting US Department of Justice toll free ADA Information line at (800) 514-0301(voice), (800) 514-0383 (TDD) and website link https://www.ada.gov/childqanda.htm.

Licensee was reminded that all adults 18 and over living or working in the home, 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.

Rooms that are off-limits need to be made inaccessible during operating hours. NO smoking, NO infant walkers, NO Johnny jumpers, NO saucer chairs, NO incline sleepers and any other item that falls into that category are permitted in the facility. Effective January 1, 2010, licensees of family child care homes are required to ensure that at least one staff member with current training in pediatric first aid and pediatric CPR is on site at all times when children are present.



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.

LPA reviewed and issued the LIC 311D - Forms/Records to Keep in Your Family Child Care Home. Mandatory Forms for the children’s files and staff files, requirements for fire drills, earthquake drills and documentation were discussed. Role and responsibilities of being a Mandated Reporter were reviewed. The Licensee was advised how to access forms and Regulations online at www.ccld.ca.gov. Licensee was made aware that it is his/her responsibility to know the regulations as well as anyone who assists in providing care.

SUPERVISORS NAME: Rita Ramos
LICENSING EVALUATOR NAME: Joe Katrdzhyan
LICENSING EVALUATOR SIGNATURE:

DATE: 04/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/15/2024
LIC809 (FAS) - (06/04)
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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: AVETISYAN FAMILY CHILD CARE
FACILITY NUMBER: 197495155
VISIT DATE: 04/15/2024
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AB 1207: Beginning on January 1, 2018, this law requires all licensed providers, applicants, directors and employees to complete training as specified on their mandated reporter duties and to renew their training every two years. Volunteers are encouraged but not required to take the training. Website: http://www.mandatedreporterca.com/

Senate Bill 792: this bill, commencing September 1, 2016, prohibits a person from being employed or volunteering at a child care facility or family day care if he or she has not been immunized against influenza, pertussis and measles. LPA discussed the influenza waiver during the visit.

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.

MyChildCarePlan.org – Centers and Family Child Care Homes Licensee [or facility representative] 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. Megan’s Law - Family Child Care Homes

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.

The following corrections will need to be made prior to granting the capacity increase;

  • The door to the gate/fence (located by the pool) self closes but does not self latch. The self latching mechanism needs to repaired/replaced.
  • Licensee will submit a new facility sketch (floor plan) matching the layout of the house. The facility sketch must label the rooms, and identify the "off limit" areas to children. Door and window exits from the rooms must be shown in case of an emergency. Room sizes/dimensions must be listed on the sketch.
SUPERVISORS NAME: Rita Ramos
LICENSING EVALUATOR NAME: Joe Katrdzhyan
LICENSING EVALUATOR SIGNATURE:

DATE: 04/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/15/2024
LIC809 (FAS) - (06/04)
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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: AVETISYAN FAMILY CHILD CARE
FACILITY NUMBER: 197495155
VISIT DATE: 04/15/2024
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  • LPA observed large bricks and trees/shrubs located in the play yard, which can be a hazard to children. Per Licensee, fencing will be installed separating the play area from the bricks and trees/shrubs.
  • LPA observed a "Gorilla Skyline Lookout Outdoor 3 Story Playset" located in the play yard which is not age appropriate for children under the age of three (3) years old. Per Licensee, perimeter fencing will be installed around the "Gorilla Skyline Lookout Outdoor Playset", ensuring it is inaccessible to children under the age of three (3) years old.
  • Immunization records for Assistant / Alyona Khachatryan will be translated to English, using a notary service.

A notice of site visit was given and must remain posted for 30 days.

An exit interview was conducted and a copy of this report, along with the appeals rights were issued to the Licensee.


Applicant to correct items by 5/15/24.
SUPERVISORS NAME: Rita Ramos
LICENSING EVALUATOR NAME: Joe Katrdzhyan
LICENSING EVALUATOR SIGNATURE:

DATE: 04/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/15/2024
LIC809 (FAS) - (06/04)
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