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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197700874
Report Date: 12/23/2024
Date Signed: 12/23/2024 02:38:07 PM

Document Has Been Signed on 12/23/2024 02:38 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 CC RO, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME:KHACHIKYAN FAMILY CHILD CAREFACILITY NUMBER:
197700874
ADMINISTRATOR/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 0DATE:
12/23/2024
TYPE OF VISIT:PrelicensingANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:20 PM
MET WITH:Insessa Khachiyan, ApplicantTIME VISIT/
INSPECTION COMPLETED:
01:52 PM
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On Monday, December 23, 2024, Licensing Program Analyst (LPA) Mayra Rivera conducted an announced pre licensing inspection and met with applicant Inessa Khachikyan who granted access. This visit is to follow up in regards corrections that were needed during the pre-licensing inspection from December 6, 2024.

LPA observed an installed gate barrier on the bottom of the staircase, a cover on the BBQ grill, and remeasured the in-ground spa. LPA measured and observed the in-ground spa to be fenced all around and measured the height of the mesh fence from the ground up to the top of the fence to be 5.0 ft high and fence does not obscure the spa from view. The bottom opening is no more than two inches on the soft surface. LPA observed the opening to be one inch open. The railing next to the gate, LPA observed the opening gap closed with mesh material. LPA observed the door gate to be 6 ft and swings away from the pool and the self-latching device is no more than 6 inches from the top of the gate.

LPA reminded applicant about new AB-2866 Pool safety: State Department of Social Services regulated facilities starts in January 1, 2025.. LPA observed an in-water pool alarm and heard the sound when applicant made water movement. LPA also observed a life ring and reviewed the purchased receipt order that indicates the exterior diameter is 20 inches and labeled as approved by the United States Coast Guard. LPA observed a rescue pole with a body hook and with the length of 12 feet. LPA reminded the applicant as of January 1, 2025, applicant shall be performing daily inspection of the drowning prevention and maintain a log of the inspections. LPA reminded applicant, the mesh fencing must not be removed and no ladders or any climbing equipment near the fencing. LPA informed applicant, if in the future the fencing needs to be replaced, applicant will need to contact the department to notify about the change.

LPA observed the gate installed on the right side yard to prevent children access to the side yard..

Exit interview conducted and report was reviewed with the Inessa Khachikyan..

SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Mayra Rivera
LICENSING EVALUATOR SIGNATURE: DATE: 12/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/23/2024
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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