197700667-2-20-2026-12-CC-CALI-DRGQZ8-20260220113619

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197700667
Report Date: 02/20/2026
Date Signed: 02/20/2026 11:36:41 AM

Document Has Been Signed on 02/20/2026 11:36 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
PALMDALE CC RO, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME:	BARSEGIAN FAMILY CHILD CARE		FACILITY NUMBER:	197700667
ADMINISTRATOR/ DIRECTOR:	GAIANE BARSEGIAN		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(818) 423-6933
CITY:	ARLETA	STATE: CA	ZIP CODE:	91331
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS: 5	DATE:	02/20/2026
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	10:00 AM
MET WITH:	GAIANE BARSEGIAN, Licensee		TIME VISIT/ INSPECTION COMPLETED:	11:45 AM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	On February 20, 2026, Licensing Program Analyst (LPA) Crystal Ali conducted an unannounced annual random inspection. The LPA disclosed the purpose of the inspection and was granted entry by the Licensee. The Licensee guided the LPA on a tour of the home. Upon entry to the facility, the LPA observed 8 children in care and licensee and assistant providing care and supervision. Licensee states that there are no other adults in the home. LPA observed all adults in the home have an approved criminal background clearance. Licensee's facility child roster is not up to date upon LPA arrival. Licensee updated the LIC 9040 during the inspection. There are no IMS children. The operational childcare hours are Monday through Friday from 8am to 5pm. Currently no infants enrolled. Staffing Ratio and Capacity: This is a one-story family home which consists of 3 bedrooms, 2 restrooms, a kitchen, dining room, living room, one shed and backyard. There is another back home with a different address on the same premises. The second home is separate and gated all around inaccessible to children in care. The dining room and living room is the primary location in which care is provided referred to as the Child Care Play Area. Bedroom #2 is utilized for napping (door remains open while children are napping). Children utilize the restroom located to the right from the main entrance of the home next to the napping room which is room #2.

NAME OF LICENSING PROGRAM MANAGER: Francisco Pedroza
NAME OF LICENSING PROGRAM ANALYST: Crystal Ali
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 02/20/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/20/2026

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: BARSEGIAN FAMILY CHILD CARE	FACILITY NUMBER: 197700667
	VISIT DATE: 02/20/2026

NARRATIVE

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The off-limit areas (maintained key locked) are the master bedroom #1, bathroom #2, bedroom #3 office, kitchen (safety gate), and the shed maintained locked utilized for equipment and toy storage. Per the Licensee, there is no smoking, no weapons, and no pets on the premises.
Physical Plant: The daycare areas are the living room, dining room, kitchen, bathroom #1, bedroom #1 (napping), and backyard. The home 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. There are no window blind cords in the home. There is a cell phone, always charged and kept with licensee. There are age-appropriate toys and equipment on the premises. The First Aid kit included a temperature thermometer, tweezer, scissors, gauzes, and cleansing pads/solution was observed to be complete and inaccessible to children kept high in kitchen top cabinet to the left of the refrigerator. There is no fireplace in the home.
Napping: Children are provided napping in bedroom #1. Napping begins around 1:00pm. LPA observed several cots and blankets set up and ready for children. Children take their blankets home to have parents wash them weekly. Licensee states that if children do not come with blankets we provide for them.
Transportation: The licensee does not provide transportation.
Kitchen: Kitchen is off limits. Knives are kept in the kitchen counter in a locked box, inaccessible to children in care. Medication is kept in the kitchen in a top cabinet to shelf above knives, inaccessible to children in care.

NAME OF LICENSING PROGRAM MANAGER: Francisco Pedroza
NAME OF LICENSING PROGRAM ANALYST: Crystal Ali
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 02/20/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/20/2026

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: BARSEGIAN FAMILY CHILD CARE	FACILITY NUMBER: 197700667
	VISIT DATE: 02/20/2026

NARRATIVE

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Licensee reports that there are no children on medication. Cleaning supplies and chemicals are kept in the inaccessible under the kitchen sink area away from children in care and in locked shed. Children with allergies is written on the child file. Licensee states there are no children with allergies at this time. Licensee participates in the Kids Care Food Care provides children enrolled with breakfast, lunch, afternoon snack and dinner. Per Licensee, the Kids Care Food Care representative came in December 2025, no concerns.
Fire Extinguisher: The required fire extinguisher (2A10BC) is reading in green and in located the wall in kitchen near door. Fire and Disaster drills are conducted at least every six-months, last drills were recorded on 1/12/26 (earthquake) and 1/13/26 (fire) for Earthquake/Disaster and Fire Drill. Licensee stated they will complete fire/earthquake drill this month. Licensee states that the fire marshall came last when the home was licensed for large capacity in 2023.
Bathroom: The daycare bathroom is located across from the living room and dining room. It has 1 sink, 1 toilet and 1 shower. Bathroom is clean and in good repair. LPA observed three potty training toilets and safety latch on cabinet under the sink.
Outdoor Space Activity: The outdoor area is the backyard. The back yard is free of sharp objects, broken toys/furniture & equipment, and other debris. The backyard is separated by a white locked fence from the other home on the property. LPA observed in the on-limit backyard area, a playhouse, large play equipment, several tricycles, and a shed. The backyard has three areas where the fence is locked for safety from off-limit areas. LPA observed one tricycle with no handlebar cover. Licensee states she will remove the tricycle and repair the handlebar rubber before children can use it.

NAME OF LICENSING PROGRAM MANAGER: Francisco Pedroza
NAME OF LICENSING PROGRAM ANALYST: Crystal Ali
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 02/20/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/20/2026

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: BARSEGIAN FAMILY CHILD CARE	FACILITY NUMBER: 197700667
	VISIT DATE: 02/20/2026

NARRATIVE

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Records/Documentation: LPA reviewed with facility representative the LIC 126, records to be maintained at the facility, for child’s records, personnel records, administrative records, and parent board. Licensee was able to provide valid Pediatric CPR/First Aid that expires 2/3/26. Licensee states she and assistant are registered for CPR/FA on 3/1/26 with American Heart Association. Licensee states she will send proof of completion to LPA. Child Care Provider Mandated Reporter Training Certificate has been completed expires 2/1/28. Assistant file is complete. Children’s (2) records files are complete. Licensee had all the required posted documents: Facility License (LIC 203A, Notice of Parent's Rights Poster (PUB 394), Emergency Disaster Plan (LIC 610A), and Earthquake Preparedness Checklist (LIC 9148).
Criminal Record Clearance - Family Child Care Homes
Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.
Safe Sleep - Family Child Care Homes
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.

NAME OF LICENSING PROGRAM MANAGER: Francisco Pedroza
NAME OF LICENSING PROGRAM ANALYST: Crystal Ali
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 02/20/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/20/2026

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: BARSEGIAN FAMILY CHILD CARE	FACILITY NUMBER: 197700667
	VISIT DATE: 02/20/2026

NARRATIVE

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Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. 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/.
MyChildCarePlan.org – Family Child Care Homes
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.
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.

No deficiencies cited in accordance with Title 22 of the California Code of Regulations and/or Health & Safety codes.

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

Exit interview conducted and report was reviewed with the licensee, Gaiane Barsegian.

NAME OF LICENSING PROGRAM MANAGER: Francisco Pedroza
NAME OF LICENSING PROGRAM ANALYST: Crystal Ali
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 02/20/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/20/2026

LIC809 (FAS) - (06/04)

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