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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197700474
Report Date: 04/05/2021
Date Signed: 04/06/2021 01:09:35 PM

Document Has Been Signed on 04/06/2021 01:09 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
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME:BARAKEZIAN FAMILY CHILD CAREFACILITY NUMBER:
197700474
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 14CENSUS: 0DATE:
04/05/2021
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
11:43 AM
MET WITH:Armenui BarakezianTIME COMPLETED:
12:45 PM
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Licensing Program Analyst (LPA) Victoria Hunt conducted a Tele-Visit with applicant Armenui Barakezian, who guided analyst on a tour of the facility for a pre-licensing inspection. This visit was held virtually due to COVID-19 Emergency Response.

This family child care home consist of 3 bedrooms and 3 bathrooms. This is a two story home. There is a kitchen, dining room, living room, and an attached garage. The garage was inspected during this inspection. The garage is used for storage only, and is off limits to children. The garage was observed to locked during the time of this inspection. Residing in the residence is the two applicants, spouse, and 1 other adult.

This home was inspected for safety, comfort, cleanliness, telephone service, central air and heat and ventilation. Also for inaccessibility to poisons, detergents, cleaning compounds, medicines, and other hazardous items that can pose a danger to children. Per applicant, there are no weapons or firearms on premises; LPA did not observe any firearms during this inspection. There are no pools, spas, or bodies of water on the premises at this home.
SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Victoria Hunt
LICENSING EVALUATOR SIGNATURE: DATE: 04/05/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/05/2021
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
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: BARAKEZIAN FAMILY CHILD CARE
FACILITY NUMBER: 197700474
VISIT DATE: 04/05/2021
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Main care is conducted in the bedroom downstairs. In the designated playroom LPA observed age appropriate toy and furniture that the child have access to. Small tables along with chairs were observed in the playroom. Also observed, are cubbies in which children can store their belongings, toys store in plastic containers located on shelves.

Books, games and toys were observed to be on shelves and or stored in cubbies. All toys and furniture on the premises of this facility and in good condition and free of cracks or repairs. Mats on the floor were clean and sanitary and provided educational/learning activities for the children.

There is a fireplace that is inaccessible to children, observed in the living room. The fireplace was observed to be screened and barricaded. Children utilize a bathrooms located in the playroom. The bathrooms were inspected and observed to have a operational sinks and toilets. The both bathrooms were observed to have child proof latches on the front door of the cabinet in good condition at the time of the inspection.

The kitchen was inspected for proper storage of all cleaning detergents, medications, and sharp pointed objects. During the inspection of the kitchen LPA observed sharp knives and other sharp objects are stored in a cabinet that has a child proof latch on it. All lower cabinets in the kitchen were observed to have child proof latches that were in good condition.



All off limits area include: All bedroom upstairs, and the garage. A security gate was observed to be located on the staircase that prevent children from accessing the upstairs bedrooms.

The backyard was inspected and was observed to be enclosed by a wooden fence. Small play toys were observed on the backyard, along with a metal play swing/slide play apparatus that is secured anchored to the ground. All toys observed in the back yard were observed to be in good condition free of cracks. AC/Heating Unit was gated and inaccessible to children.
SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Victoria Hunt
LICENSING EVALUATOR SIGNATURE:

DATE: 04/05/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/05/2021
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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
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: BARAKEZIAN FAMILY CHILD CARE
FACILITY NUMBER: 197700474
VISIT DATE: 04/05/2021
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 All electrical outlets were covered in the home. There is a first aid kit on premises. LPA observed that applicant has a fire extinguisher 2A10BC which meets fire marshal standards. Smoke detector was tested and is in operational condition. Applicant has at least one working carbon monoxide detector located in the playroom. Licensee and assistant have a Pediatric CPR & First Aid is valid until: 11/2021 as indicated on the certificate. Applicant has the required immunization's : Measles , pertussis and declined the flu. The applicant has also completed the 1207 Mandated Reporter Training.

Licensee is not be providing medication to children. Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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

There shall be no smoking, no infant walkers, johnny jumpers, exersaucers and any other item that falls into that category. Also discussed were earthquake, fire & disaster drills shall be documented at least once every six months.



LPA discussed licensing capacity requirements. Licensee understands the ratio and capacity requirements. Licensee understands that any cleared adult left alone caring for children must have a background clearance check and current Pediatric 1st Aid and CPR certificates. Licensee advised that children residing in the home under the age of 10 count towards capacity/ratio.

If licensee is operating a large family child day care and no assistant provider is present at a Large Family Child Care Home, then the licensee shall comply with the capacity requirements for a Small Family Child Care Home. Therefore, the large family childcare reverts to small capacity requirements of (8) children.
SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Victoria Hunt
LICENSING EVALUATOR SIGNATURE:

DATE: 04/05/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/05/2021
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
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: BARAKEZIAN FAMILY CHILD CARE
FACILITY NUMBER: 197700474
VISIT DATE: 04/05/2021
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Posting requirements were discussed such as the posting of the Parent’s Rights poster in a visible location for the children’s authorized representatives. Children records requirements, mandated child abuse and injury/ death reporting, background check clearance transfer requirements, SIDS, Infants Safe Sleep on Back, and Never Shake A Baby were all discussed. Licensee agrees children shall be positioned for sleep on their back. During this inspection LPA discuss COVID-19 procedures and provided applicant with flyers to post in the facility. LPA also, discussed new Safe Sleep Regulations.

No deficiencies were cited today, this facility was found to be operating in substantial compliance of Title 22 Regulations. A copy of this report was discussed with the applicants. A copy of this report was discussed will be sent electronically. This facility is approved for licensure effective 04/05/21.

SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Victoria Hunt
LICENSING EVALUATOR SIGNATURE:

DATE: 04/05/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/05/2021
LIC809 (FAS) - (06/04)
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