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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197700302
Report Date: 04/22/2026
Date Signed: 04/22/2026 02:28:42 PM

Document Has Been Signed on 04/22/2026 02:28 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
PALMDALE CC RO, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME:TELEMI FAMILY CHILD CAREFACILITY NUMBER:
197700302
ADMINISTRATOR/
DIRECTOR:		SHAGHIK TELEMIFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(818) 418-9139
CITY:SUNLANDSTATE: CAZIP CODE:
91040
CAPACITY: 14TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
04/22/2026
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:35 PM
MET WITH:Shaghik Telemi, LicenseeTIME VISIT/
INSPECTION COMPLETED:
02:45 PM
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On Wednesday, April 22, 2026, Licensing Program Analysts (LPAs) Evelyn Garcia and Maria Avalos met with Licensee Shaghik Telemi who guided analyst on a tour of the facility for an unannounced annual inspection. LPA disclosed the purpose of the inspection and was granted entry by the licensee, who guided LPAs on a tour of the facility. Building permit was approved by the City of Sunland and copy was submitted to the Palmdale Regional Office. Upon arrival, LPAs observed 0 children in care and per licensee there are no children enrolled. Family members living in the home are Licensee, Licensee’s spouse, and 2 minor children. All adults have been fingerprinted and cleared. Hours of operation are provided 8:00am-5:00pm, Monday through Friday. Incidental Medical Services (IMS) policy was discussed.

Physical Plant: The main house is a one-story house with 2 bedrooms, and 1 bathroom, living room, kitchen, office, attached garage, and front/back yards. There is no pool/spa or body of water on the premises. Per Licensee, main care will be provided in the attached converted garage which is designated as the main childcare area. LPA observed several age appropriate toys and furniture in good condition. The address for the main house is 10321 Parr Ave, Sunland, CA 91040. The ADU is located on the same lot and attached to the main house and is located at 10323 Parr Ave, Sunland, CA 91040.

Children use the bathroom located in the hallway on the right. Accessible areas include ADU living room, ADU family room, ADU kitchen, bathroom #1 in the ADU, back yard, and bathroom #2 in the main house. Off limit areas include bedrooms 1-2, main house living room, main house kitchen, and front yard. The home was inspected inside and out for safety, clean and orderly, comfort, cleanliness, telephone service, heating and ventilation, inaccessibility to poisons, detergents/cleaning compounds, and medicines. Hazardous items (sharp knives are stored in the off-limits main house kitchen drawer with a safety latch, cleaning detergents/compounds in the ADU kitchen underneath the sink with an operable safety latch with an operable safety latch, and per Licensee, there are no medications in the home/ inaccessible to children in care.

NAME OF LICENSING PROGRAM MANAGER: Francisco Pedroza
NAME OF LICENSING PROGRAM ANALYST: Maria Avalos
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 04/22/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/22/2026
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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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)
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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
PALMDALE CC RO, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: TELEMI FAMILY CHILD CARE
FACILITY NUMBER: 197700302
VISIT DATE: 04/22/2026
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Safe and age-appropriate toys, play equipment and materials were observed. LPA tested the smoke detector and carbon monoxide detector and observed both to be in operable condition. Fire clearance was granted on 1/7/2025. Fire extinguisher (2A10BC) was observed to be in operable condition located at the entrance of the ADU and serviced on 3/9/26. Electrical outlets were inaccessible. No recalled and or prohibited toys or play equipment were observed on the premises. There is a designated area for ill children as necessary.

Bathroom: Bathroom #1 is located in the hallway in the ADU. The toilet and sink are in operable condition. Bathroom #1 was observed to be a full bathroom with a shower/tub combination. The bathroom was observed to be free of hazards. Bathroom #2 is located in the main house. Bathroom #2 was observed to be a full bathroom with a shower/tub combination. Children will access bathroom #2 from the back yard and through a sliding door into the main house. The following are inaccessible: Sharp items, mouthwash, shampoo, razor, nail polish. Toilet and faucet are clean and operable.

Kitchen: The ADU has a clean and fully stocked clean refrigerator/freezer. The kitchen was observed to be clean and sanitary. Breakfast, lunch, and snacks are provided. Licensee was reminded all food items brought from the children’s home shall be properly stored, labeled, and dated. Licensee is a participant in a food program. Sharp items are inaccessible to children in care.

Outdoor: Children play in the back yard. The play area is clear and clean of debris, play area is fenced and gated all around. LPA observed the back yard to be accessible through a sliding door in the back of the ADU which is made inaccessible by a safety gate. LPA observed the outdoor air conditioner in the backyard inaccessible. LPA observed age-appropriate toys for children.

Pools/Spas/Bodies of Water: There are no pools, spas, or bodies of water on the premises.

Advisory/Other: First Aid kit was observed with supplies readily available. Licensee’s Pediatric First Aid/CPR is dated 4/9/26. Licensee’s Mandated Reporter training dated, 9/10/24. LPA reminded licensee mandated reporter training and First Aid/CPR must be completed every 2 years. Licensee was advised online First Aid/CPR courses cannot be accepted and all in person courses must be EMSA approved. For more information about First Aid/CPR courses, please visit, https://emsa.ca.gov/childcare_provider/. Additionally, Licensee stated there is no smoking of any kind in the home. Licensee has no children in care. Licensee shall conduct a fire/disaster drill when children are present.

NAME OF LICENSING PROGRAM MANAGER: Francisco Pedroza
NAME OF LICENSING PROGRAM ANALYST: Maria Avalos
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 04/22/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/22/2026
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
PALMDALE CC RO, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: TELEMI FAMILY CHILD CARE
FACILITY NUMBER: 197700302
VISIT DATE: 04/22/2026
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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.

Any duly authorized officer, employee, or agent of the Department shall, upon presentation of proper identification, shall inspect the facility. The Licensee shall permit the Department to inspect the family childcare home, and to privately interview children or staff, to determine compliance with or to prevent violations of family child care laws or regulations, also enter and inspect any place providing personal care, supervision and services at any time, with or without advance notice, to secure compliance with, or to prevent a violation.

Licensee advised of the requirement to report Unusual Incidents. Licensee informed to utilize the Unusual Incident Report/Injury Report LIC624B when submitting the report to the department (email address on the website: www.unusualincidentreport@dss.ca.gov. A report shall be made to the department by telephone or fax during the department's normal business hours before the close of the next working day following the occurrence during the operation of family day care home. In addition, a written report shall be submitted to the department within seven days following the occurrence of any events specified above.

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-andresources/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.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02CCP. 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/.

NAME OF LICENSING PROGRAM MANAGER: Francisco Pedroza
NAME OF LICENSING PROGRAM ANALYST: Maria Avalos
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 04/22/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/22/2026
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
PALMDALE CC RO, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: TELEMI FAMILY CHILD CARE
FACILITY NUMBER: 197700302
VISIT DATE: 04/22/2026
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Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain childcare by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

Licensee provided proof of control of property.

There are no deficiencies being cited today.

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

Exit interview conducted and report was reviewed with the licensee.

NAME OF LICENSING PROGRAM MANAGER: Francisco Pedroza
NAME OF LICENSING PROGRAM ANALYST: Maria Avalos
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 04/22/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/22/2026
LIC809 (FAS) - (06/04)
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