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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197700722
Report Date: 05/14/2025
Date Signed: 05/14/2025 02:48:00 PM

Document Has Been Signed on 05/14/2025 02:48 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:MKRTCHYAN FAMILY CHILD CAREFACILITY NUMBER:
197700722
ADMINISTRATOR/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 8DATE:
05/14/2025
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:25 PM
MET WITH:Nara Mkrtchyan, LicenseeTIME VISIT/
INSPECTION COMPLETED:
03:10 PM
NARRATIVE
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On 05/14/2025, Licensing Program Analyst (LPA) Justeene Tamayo conducted a case management inspection for a Capacity Increase Inspection with licensee Nara Mkrtchyan, who guided LPA on a tour of the facility. This is a one-story house with 3 bedrooms, and 2 bathrooms, living room, dining room, and kitchen. Upon arrival, LPA observed 1 infant and 7 preschool children in care. The adults residing in the home are 3 adults(licensee, licensee's husband, and licensee's adult son), and 2 minor children. The facility operates Monday through Friday, providing care from 7:00 am to 7:00 pm.

The fire department has granted a fire clearance on 05/06/2025 with a license capacity of 14. Licensee is advised that as a family childcare home operating at full capacity, she must adhere to the following: Operate with a Maximum of 14 children in care with no more than 3 Infants, also must have 2 school age children enrolled. Or Max. 12 Capacity with no more than 4 infants. A Qualified Assistant must be present when more than 8 children are in care.

During file review and observation, licensee is currently out of ratio. Licensee stated she did not know she needed 2 school age children in order to have a capacity of 8 day care children. There were a total of 1 infant and 7 preschool age children present. Facility has been cited a Type B Citation. Please see LIC809-D for deficiency page.

Main care is provided in the living room and family room area (playroom near front entrance). Children eat in the main care area. The day care children utilize the bathroom accessible through bedroom #1. Children use the side yard for outdoor play. All bedrooms, bathroom #2, and front yard are off limits to children in care.

LPA observed day care area to be clean and orderly, central air and heating, age-appropriate toys and play equipment, working smoke and carbon monoxide detectors are in operable condition.

LPA reminded licensee, the children's bathroom must be free of shampoos, mouthwash, medication, perfumes, razor, air freshener, nail polish and polish remover. LPA observed a clean, safe and operable toilet and faucet.

NAME OF LICENSING PROGRAM MANAGER: Mariela Ramon
NAME OF LICENSING PROGRAM ANALYST: Justeene Tamayo
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 05/14/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/14/2025
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
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: MKRTCHYAN FAMILY CHILD CARE
FACILITY NUMBER: 197700722
VISIT DATE: 05/14/2025
NARRATIVE
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LPA observed a fully charge 2A10BC fire extinguisher during the inspection located at the entrance. First aid kit is located in the laundry room area. Medications are stored in the upper laundry room cabinet. Cleaning items are inaccessible to children stored underneath the kitchen sink which has an operable safety magnet latch.

Kitchen: The kitchen is off limits to children in care. LPA observed a mesh safety gate barricading the kitchen area and laundry area. The kitchen was observed to be clean and orderly. The following are inaccessible: Sharp items are stored in a kitchen drawer with a safety latch. LPA observed the refrigerator and freezer to be clean. LPA discuss with licensee food shall be properly stored or refrigerated in container that are labeled with child’s name when supplied by parent. Per licensee, she cooks for the day care children. Breakfast,lunch, snacks, and dinner are provided.

Children play in the side yard gated. The front yard is off limits to children in care. LPA toured the side yard and observed it to be free of garden tools, poisonous plants, thorn trees cactus, or lawn mower inaccessible to children. LPA observed the side yard fully fenced in and safe for children. There are no bodies of water on the premises. There is turf for active play.

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.

Documents Provided and or Discussed: The following were provided to comply with Title 22 requirements: Fire Drill Log, roster, Safe Sleep PIN 20-24-CCP, Individual Sleeping Plan (LIC 9227), water lead poster, required postings and list of CCLD forms required for child file each child in care (LIC 311D). Licensee stated currently does not have childcare insurance. Child Care Advocates information: www.childcareadvocatesprogram@cdss.ca.gov

Licensee was advised of the requirement to report unusual incidents and/or injuries to the parent/guardian and Licensing within 24 hours of incident by telephone and in writing within 7 day of incident to the department. Licensee was informed all suspected Child Abuse should be reported to the Child Abuse Hot-line at 1-800-540-4000. The above incident should be reported on the form LIC624B per the regulation. The form should be email to unusualincidentreport@dss.ca.gov

NAME OF LICENSING PROGRAM MANAGER: Mariela Ramon
NAME OF LICENSING PROGRAM ANALYST: Justeene Tamayo
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 05/14/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/14/2025
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: MKRTCHYAN FAMILY CHILD CARE
FACILITY NUMBER: 197700722
VISIT DATE: 05/14/2025
NARRATIVE
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Advisory/Other: Licensee First Aid/CPR expired on 05/06/2025. Per licensee she has an appointment to retake her CPR/First Aid on 05/24/25. Licensee will send proof of completion to LPA Tamayo once completed. Facility has been cited a Type B Citation. Please see LIC809-D for deficiency page.

Fire/Disaster Drill is complete and maintained current. Last Fire/Disaster drill was completed on 03/10/2025. Mandated reporter training is complete and maintained current and expires on 06/04/2025. Licensee was advised her CPR/First Aid and mandated reporter training must be completed every 2 years.

Preventative Health & Safety training is completed. Electrical outlets are inaccessible to children. Children nap on cots in the living room. Licensee is aware no infant shall be swaddled, and car seat shall not be used for sleeping. Licensee is aware to supervise infants while they are sleeping by physically checking every 15 minutes and documenting the infant’s status. Licensee should refer to regulation 102425(J) for documentation requirement. If the infant’s Individual Infant Sleeping Plan [LIC 9227 (3/20)] does not have Section C completed, the provider shall return the infant to their back for sleeping. LPA discussed the safe sleep regulations with applicant, including Safe Sleep PIN 20-24-CCP and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed applicant 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.

Licensee was informed smoking is prohibited. Licensee further stated stated no one smokes in the home. LPA discussed Health Section 1596.846(b) and (c)–102417 (g)(10) and provided licensee with a visual copy of prohibited items. LPA did not observe prohibited items during the inspection. Per licensee no firearms are present in the home. Licensee was informed her cell phone shall be available and always charged during daycare hours.

Incidental Medical Services (IMS) policy was discussed, informing licensee when any IMS is provided, a plan for providing IMS must be submitted to the Department prior to providing care to a child that need IMS. The plan shall state the type of IMS the facility will be offering, stating the person providing care has been trained to provide the named IMS. The plan will also provide the steps that will be taken when IMS is provided to a child.

At this time, LPA Tamayo will need to conduct a Plan of Correction visit to ensure licensee is following ratio requirements before approval of capacity increase.

Exit interview conducted copy of this report was provided to licensee, along with Notice of Site visit and Appeal Rights.

NAME OF LICENSING PROGRAM MANAGER: Mariela Ramon
NAME OF LICENSING PROGRAM ANALYST: Justeene Tamayo
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 05/14/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/14/2025
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 05/14/2025 02:48 PM - It Cannot Be Edited


Created By: Justeene Tamayo On 05/14/2025 at 02:25 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: MKRTCHYAN FAMILY CHILD CARE
FACILITY NUMBER: 197700722

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/14/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
05/21/2025
Section Cited
CCR
102416(c)

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Personnel Requirements 102416(c):The licensee and other personnel as specified shall complete training on preventive health practices..pediatric cardiopulmonary resuscitation and pediatric first aid, pursuant to Health and Safety..
This requirement is not met as evidenced by:
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Licensee currently scheduled an appointment to retake her CPR/First Aid on Saturday 05/24/25. Licensee will send proof of picture no later than 05/26/2025.
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Based on record review, the licensee did not comply with the section cited above. Licensee's First Aid/CPR expired on 05/06/2025, which poses/posed a potential health, safety or personal rights risk to persons in care.
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Type B
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Section Cited
CCR102416.5(b)(3)

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Staffing Ratio and Capacity 102416.5(b)(3): For a Small Family Child Care Home, the maximum number of children for whom care may be provided at any one time.. shall be one of the following.. More than six and up to eight children... only if the criteria... are met.
This requirement was not met as evidenced by:
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An unnanounced Plan of Correction Visit will be conducted at a later date to ensure licensee is following ratio requirements.
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Based on observation and record review, the licensee did not comply with the section cited above. LPA observed 1 infant and 7 preschool age children in care, which poses a potential health, safety or personal rights risk to persons in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Mariela Ramon
NAME OF LICENSING PROGRAM MANAGER:
Justeene Tamayo
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 05/14/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/14/2025


LIC809 (FAS) - (06/04)
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