197700751-11-3-2023-12-CC-EGAA-CX8QHG-20231103121107

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197700751
Report Date: 11/03/2023
Date Signed: 11/03/2023 12:11:23 PM

Document Has Been Signed on 11/03/2023 12:11 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:	AIVAZIAN & MIKAEILIAN FAMILY CHILD CARE		FACILITY NUMBER:	197700751
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 8	CENSUS:	DATE:	11/03/2023
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME BEGAN:	09:55 AM
MET WITH:	Andre Aivazian and Lucine Mikaeilian		TIME COMPLETED:	12:30 PM

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On Friday, November 3, 2023, at 9:55 a.m., Licensing Program Analyst (LPA) Evelyn Garcia conducted an announced pre licensing inspection and met with applicant Andre Aivazian and Lusine Mikaeilian who guided LPA Garcia on a tour of the facility. The applicant is requesting a small family childcare license.

Family members residing in the home has been discussed with applicant and are cleared. Operating hours will be Monday to Friday from 8:00 a.m. to 5:30 p.m. and care for children ages 0 to 12.

This facility is a one story home that consists of 3 bedrooms,2 bathrooms, kitchen, den (Back of house), Livingroom (daycare), dining room, laundry room, fireplace that is completely barricaded by large shelves and inaccessible to children and front and backyard fenced.

Areas off limits to children include- Bedroom 2 and 3, bathroom 2, kitchen, dining room, laundry room, den (living room), and front yard. Areas accessible to children include bedroom 1 (nap/ play), living room (daycare) and bathroom located in the hallway to the right and back yard.

At approximately 9:55 a.m LPA Garcia inspected the facility for safety, comfort, cleanliness, ventilation and working phone (cell phone). For ventilation, LPA Garcia observed air conditioner/heater unit. LPA observed the furniture, children’s materials, to be in good condition and age appropriate. LPA observed cots, but will be purchasing more and will also purchase crib in case they enroll infants under 1 year old.

SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Evelyn Garcia
LICENSING EVALUATOR SIGNATURE:	DATE: 11/03/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/03/2023

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: AIVAZIAN & MIKAEILIAN FAMILY CHILD CARE	FACILITY NUMBER: 197700751
	VISIT DATE: 11/03/2023

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At approximately 10:09 a.m. LPA Garcia observed cleaning compounds items stored underneath sink in the laundry room that will be off-limits, applicants purchased lock for laundryroom door and have a safety lock that will be placed under sink for extra caution. LPA did observe knives and sharp objects in kitchen drawer, however the kitchen will be off limits for the children making them inaccessible to the children in care. For water drinking, applicants stated they will be providing filtered water from a dispenser and disposable cups that LPA observed. Applicants stated they will be providing the meals for the children. LPA informed applicant food brought from the children's homes,shall be labeled with the child's name and properly stored or refrigerated.

At approximately 10:13 a.m., LPA Garcia entered the restroom and observed the toilet, hand washing sink, hand soap and LPA observed the bottom sink cabinet closed and was empty. LPA did not observe hazard materials and observed the restroom to be in good condition. Shampoos and body washes were observed in the shower, however applicants stated they will remove them and only use them in bathroom #2.

LPA Garcia asked applicant if there are any pets, poisons, firearms, weapons, or bodies of water. Applicants stated there are no pets, no poisons and no bodies of water, no firearms, and no weapons. Applicant was advised that if any poisons (ex; drano, rat poison or items that fall into that category), firearms and weapons are purchased, it is required to be locked with a key or combination lock and firearm and ammunition must be stored separately.

At approximately 10:19 a.m. LPA Garcia observed the required A40BC fire extinguisher located in bedroom #1 (naproom), Living room (day care) and Kitchen, with the valve on the green area indicating fully charged. LPA informed the applicants the fire extinguisher needs to be serviced annually or purchase a new one within a year and tape the purchase receipt. LPA observed carbon monoxide detector and smoke alarm located near the front door. Applicant tested the carbon monoxide and smoke alarm. LPA Garcia heard the sounds and are operable. LPA observed the first aid complete with band aids, gauzes, adhesive bandages, and antiseptic wipes and located in the daycare area not accessible to children on a high shelf. For ill isolation, applicant stated bedroom #1 will be utilized. Applicants stated they have a thermometer but could not be found at the moment. They will find and place in an accessible area.

At approximately 10:24 a.m., LPA Garcia inspected the play outdoor (back yard) area that will be used by children for safety, comfort, and cleanliness. LPA observed the yard with grass and concrete. LPA observed the front yard to be gated. LPA observed the equipment to be in a safe condition, free of sharp, no lose or pointed parts. The surface of the outdoor activity space is maintained in a safe condition and is free of hazards.

SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Evelyn Garcia
LICENSING EVALUATOR SIGNATURE:	DATE: 11/03/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/03/2023

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: AIVAZIAN & MIKAEILIAN FAMILY CHILD CARE	FACILITY NUMBER: 197700751
	VISIT DATE: 11/03/2023

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LPA observed play equipment to be age appropriate and applicants were informed that high climbing equipment, are to be are cushioned with rubber mat or stay on soft grassy area. garage was observed to be closed and locked with a key lock.

LPA observed applicant from A-B-CPR & First pediatric training that is EMSA approved. Pediatric First Aid/ CPR certification and Health and Safety certification dated August 12, 2023 for both applicants and applicants have proof of immunization against Pertussis, MMR and Influenza declination. Applicant has completed the mandated reporter (AB 1207) training dated 2/5/23 and 7/23/23. Applicants were advised that the mandated reporter training must be completed every 2 years, and is available at www.mandatedreporterca.com

Applicants stated they plan to care for children 0-12years old. LPA informed Applicants of the new Safe sleep regulations, including LIC 9227 Infant Sleep Plan for infants under 12 months and 15-minute sleep check documentation for infants 0-24 months. LPA provided the LIC 9227 Individual Infant Sleeping Plan and Safe Sleep Log form.

During the inspection, applicants posted the required postings LIC 610A Emergency Disaster Plan, Pub 394 Notification of Parents Rights, LIC 999 Facility sketch, and child car seat law poster. LPA informed applicants, the required posting need to be posted in the area where parent can view the information.

The following was also discussed with the applicant:

1. Refused Entry to a Facility or Any Part of a Facility is a violation of Section 1596.852, 1596.853 or 1597.09. Regulations 101238 (g) (2), The Presence of an Excluded Individual, Fire Clearance Violations, Accessible Bodies of Water, Accessible Firearms, Ammunition or Both

2 Pediatric First Aid and CPR: American Heart Association or American Red Cross or Emergency Medical Services Authority (EMSA) approved in Pediatric First Aid and CPR must be present.

3. In the absence of the licensee a qualified adult must be present, supervising the children; a qualified adult is an individual who has a valid and current Pediatric first aid/ CPR-adult-child- infant certification (EMSA approved), a valid criminal record clearance associated to the facility license, immunization's (MMR, TDAP, TB and Influenza or Influenza declination), AB 1207 Child Abuse Mandated Reporter Certificate.

SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Evelyn Garcia
LICENSING EVALUATOR SIGNATURE:	DATE: 11/03/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/03/2023

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: AIVAZIAN & MIKAEILIAN FAMILY CHILD CARE	FACILITY NUMBER: 197700751
	VISIT DATE: 11/03/2023

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4. A current roster of children enrolled must be available and maintained for a period of 3 years, even after children are no longer attending the facility.

5. Annual fees must be paid promptly and by the due date or a late fee shall be assessed and/or the license shall be terminated

6. The fire extinguisher must be serviced annually or as often as necessary and smoke and carbon monoxide detectors should be checked, and batteries replaced as needed.

7. Changes should be reported to the Department as soon as they occur such as construction, remodeling, telephone number changes and/or if you move from your home.

8. Any unusual incidents or injuries must be reported to the Department within 24 hours via telephone and within seven (7) days in writing (refer to LIC 624B). Mandated reporter requirements were reviewed and explained.

9. Fire and safety drills must be performed every six (6) months and documented for review by the Department.

10. Smoking is prohibited in the family childcare home.

11. Children and staff records must be maintained and updated as needed and be available for review by the Department.

12. Immunization Requirement: H&S 1597.622: Commencing September 1, 2016, a person shall not be employed or volunteer at a family day care home if he or she has not been immunized against influenza, pertussis, and measles. The licensee and all adults working with children have proof of immunizations.

13. Inspection Authority: All adults living and working in the home shall be made of aware of the Department’s right to inspection the home, which includes, but is not limited to the right to enter the home when children are being cared for, interview children and adults and review documentation.

14. The facility license number must be on all advertisements, publications, or announcements with the intent to attract clients.

SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Evelyn Garcia
LICENSING EVALUATOR SIGNATURE:	DATE: 11/03/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/03/2023

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: AIVAZIAN & MIKAEILIAN FAMILY CHILD CARE	FACILITY NUMBER: 197700751
	VISIT DATE: 11/03/2023

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15. Isolation for Ill children: When a child is ill, he/she shall be separated from other children (reference 102417(e) Operation of a Family Child Care Home).

16. Liability Insurance was discussed; LPA advised applicant to review Title 22 Regulation 102417(m)(1) for additional information.

17. Dog(s) and/or pets are recommended to be isolated from children in care.

18. No baby bouncers, no infant walkers, no Johnny jumpers, no saucer chairs, and any other item that falls into this category is not permitted in the facility.

Family Child Care Homes Applicant, was reminded that all adults 18 and over living in the home, persons who provide care and supervision to children, and staff who have contact with children, 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.
Applicant owns the property and provided proof of control of property.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02CCP. 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) or (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.

Family Child Care Homes LPA reviewed with applicants the LIC311D, Forms/Records to Keep In Your Family Child Care Homes, children’s forms/records, facility forms/records, and information to be posted. LPA Garcia explained in detailed to applicants LIC 9221 Parent Consent for Administration of Medications and medication chart, LIC 9040 Child Care Facility Roster, LIC 624 Unusual Incident Report, LIC 9227 Individual Infant Sleeping Plan, Safe sleep practices, safe sleep log, the California Car Seat Law Changes (effective February 2018), and Sudden Infant Death Syndrome (SIDS).
Entrance Checklist was provided to the applicant.

SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Evelyn Garcia
LICENSING EVALUATOR SIGNATURE:	DATE: 11/03/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/03/2023

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: AIVAZIAN & MIKAEILIAN FAMILY CHILD CARE	FACILITY NUMBER: 197700751
	VISIT DATE: 11/03/2023

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Child Care Centers and Family Child Care Homes LPA discussed the safe sleep regulations with applicant, 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 [applicant, licensee, or facility representative] 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.

On this date: 9/28/23, the California Attorney General - Megan’s Law website was searched for information on sex offenders required to register with local law enforcement under California's Megan's Law. No registered sex offenders were found at the facility addresses. Under state law, some registered sex offenders are not subject to public disclosure; therefore, they may not have been included in this search. However, the Department conducts a monthly cross reference of each address on record for all registered sex offenders against all CCLD facility addresses pursuant to information shared by California DOJ.

Family Child Care Home Applicant was informed of the MyChildCarePlan.org site, a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

Family Child Care Homes: Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platforms. To receive important licensed related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-carelicensing/subscribe and select the Child Care option to receive email communication.

Exit interview conducted and report was reviewed with the applicant.

SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Evelyn Garcia
LICENSING EVALUATOR SIGNATURE:	DATE: 11/03/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/03/2023

LIC809 (FAS) - (06/04)

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