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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197700469
Report Date: 12/19/2022
Date Signed: 12/19/2022 04:43:34 PM

Document Has Been Signed on 12/19/2022 04:43 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 CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME:ARSHAKYAN FAMILY CHILD CAREFACILITY NUMBER:
197700469
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 8DATE:
12/19/2022
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
03:31 PM
MET WITH:Anzehela ArshakyanTIME COMPLETED:
04:45 PM
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Licensing Program Analyst (LPA)Isabel Ortega met with Licensee today for the purpose of conducting a Case Management inspection. Licensee has requested to add additional room to the Small Family Child Care Home. Currently there are five bedrooms (off limits) and three restrooms(off limits). Today, LPA Ortega inspected one story addition to the side of the existing detached garage that was converted with new addition into the new detached Accessory Dwelling Unit (ADU).
ADU permit #21010 20000 02783. ADU has a full kitchen with sink and stove, one restroom, a living room and one bedroom.

According to licensee main home will be utilized for pick up and drop offs. Main care will be in the ADU (LA City permit observed) referred to as the Day Care area. With ADU this is a two story home with five bedrooms and four restrooms. . Licensee provides breakfast, lunch, afternoon snack and dinner as needed. The operational child care hours are Monday through Friday varied up to 23 hours depending on family's need.

The ADU was inspected inside and out for safety, comfort, cleanliness, telephone service, heating and ventilation, inaccessibility to poisons, detergents, cleaning compounds, medicines, and hazardous items that can pose a danger to children. Knives and medication are kept in the kitchen on a top shelf, inaccessible to children. Cleaning supplies and chemicals are kept under the sink (child safety latch observed).
SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Isabel Ortega
LICENSING EVALUATOR SIGNATURE: DATE: 12/19/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/19/2022
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
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: ARSHAKYAN FAMILY CHILD CARE
FACILITY NUMBER: 197700469
VISIT DATE: 12/19/2022
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The First Aid kit with a temperature thermometer was observed and complete. The required fire extinguisher (2A10BC) is reading in green. Smoke and carbon monoxide detectors were found to be in operating condition tested. Fire and disaster drills are conducted every six-month last drill recorded was on 12/19/2022 at 4:00 p.m.

Licensee had all the required posted documents: Facility License (LIC 203, Notice of Parent's Rights Poster (PUB 394), Emergency Disaster Plan (LIC 610A), and Earthquake Preparedness Checklist (LIC 9148).

The facility was found to be in compliance per Title 22 regulations, no deficiencies will be cited today. ADU has been granted as an additional child care room. An exit interview was conducted, a copy of this Report, a Notice of Site visit and Appeal rights were provided and discussed with licensee.

All licensing reports are recommended to keep for 3 years and the Notice of Site visit is to be posted visible to parents for 30 days.

SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Isabel Ortega
LICENSING EVALUATOR SIGNATURE:

DATE: 12/19/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/19/2022
LIC809 (FAS) - (06/04)
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