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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197700561
Report Date: 03/29/2022
Date Signed: 04/06/2022 09:48:54 AM

Document Has Been Signed on 04/06/2022 09:48 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, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME:BOYAJYAN FAMILY CHILD CAREFACILITY NUMBER:
197700561
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 0DATE:
03/29/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
09:56 AM
MET WITH:Mariam BoyajianTIME COMPLETED:
12:12 PM
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On 03/29/2022 at 10:00am, Licensing Program Analyst (LPA) Liana Stepanyan conducted a Follow up Pre-licensing Inspection with Applicant Mariam Boyajyan, who guided analyst on a tour of the facility regarding the areas of concern.
LPA observed the following:
Applicant made all electrical outlets inaccessible.

Applicant made all exercising equipment inaccessible to children stored in an off-limit area.

All hazardous items such as tools, electrical wires, broom, buckets, and gardening tools were made inaccessible to children.

Applicant has first aid kit with all required items located in the kitchen.

Applicant made steps in the backyard safe for children. Applicant placed cushions on the concrete floor and has cushions covering the edges of the steps. In addition, applicant signed declaration form stating children will be supervised during out door play at all times.

Applicant has AC unit inaccessible to children located in the rear yard in off-limit area.

Applicant is ready for licensure. The applicant is in compliance with Title 22; no further corrections are needed and can be licensed as a small Family Child Care Home for a maximum of 8.



Exit interview conducted and report was reviewed with the applicant Mariam Boyajyan.
SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Liana Stepanyan
LICENSING EVALUATOR SIGNATURE: DATE: 03/29/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/29/2022
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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