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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197700894
Report Date: 11/12/2025
Date Signed: 11/12/2025 12:52:32 PM

Document Has Been Signed on 11/12/2025 12:52 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:POGHOSYAN FAMILY CHILD CAREFACILITY NUMBER:
197700894
ADMINISTRATOR/
DIRECTOR:		LARISAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(818) 442-2424
CITY:SANTA CLARITASTATE: CAZIP CODE:
91321
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 10DATE:
11/12/2025
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:36 AM
MET WITH:Larisa Poghosyan; LicenseeTIME VISIT/
INSPECTION COMPLETED:
01:00 PM
NARRATIVE
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On Wednesday, November 12, 2025, Licensing Program Analyst (LPA) Hanna Cha met with licensee Larisa Poghosyan. The purpose of the visit was to conduct an unannounced Annual/Random inspection of the facility. Upon arrival, LPA disclosed the purpose of the inspection to the licensee. LPA and licensee toured the facility. During the inspection, LPA observed licensee and assistant #1(A1) providing care and supervision to 10 children. The current days and hours of operation are Mondays through Fridays from 7:30am-6:00pm.

Physical Plant/Indoor/Childcare Area: This is a one-story family home with five bedrooms, four restrooms, a kitchen, dining room, living room, laundry room, attached garage, front and back yard. Main child care is provided in the ADU. The side gate is utilized for access to ADU. The off-limit areas include the entire main home: five bedrooms, kitchen, living room, dining room, laundry room in the attached garage (maintained key locked), and the back yard.

Childcare Bathroom: The childcare bathroom (located to the left from front door) was observed to be in safe and operating condition. Toilet and faucet are in good operable condition. LPA reminded licensee to keep shampoos, mouthwash, razors, toothpaste, and other hazardous items inaccessible to all children.

Kitchen: The kitchen (located to the right from front door) was observed for safety, sanitation, and good repair. The knives and sharp items are stored in kitchen of main home, out of reach of children. LPA reminded Licensee, if food is brought from the child’s home, the container shall be labeled with the child’s name and properly stored or refrigerated. Licensee participates in the food program and provides meals during all operational hours.

NAME OF LICENSING PROGRAM MANAGER: Mariela Ramon
NAME OF LICENSING PROGRAM ANALYST: Hanna Cha
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 11/12/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/12/2025
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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Document Has Been Signed on 11/12/2025 12:52 PM - It Cannot Be Edited


Created By: Hanna Cha On 11/12/2025 at 11:43 AM
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: POGHOSYAN FAMILY CHILD CARE
FACILITY NUMBER: 197700894

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/12/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1596.814(a)(1)(B)(ii)(I)
Pool Safety
(ii) (I) An alarm that, when placed in a swimming pool, will sound upon detecting an entrance into the water. The alarm shall be turned on and be in working condition during a facility’s operating hours while the swimming pool is not in use.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, LPA did not observe an ASTM approved pool alarm or pool cover, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 11/26/2025
Plan of Correction
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Licensee will install pool alarm pr cover for both pool and jacuzzi and provide proof to the Department by POC due date.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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:
Hanna Cha
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 11/12/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/12/2025


LIC809 (FAS) - (06/04)
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Document Has Been Signed on 11/12/2025 12:52 PM - It Cannot Be Edited


Created By: Hanna Cha On 11/12/2025 at 12:03 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: POGHOSYAN FAMILY CHILD CARE
FACILITY NUMBER: 197700894

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/12/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1596.814(a)(1)(A)
Pool Safety
(a) A licensed family daycare home operated at a private single-family dwelling with an in-ground swimming pool on the premises shall comply with all of the following requirements: (1) The swimming pool shall be equipped with, at minimum, the following drowning prevention safety features: (A) An enclosure, including, but not limited to, a fence, wall, or other barrier that isolates the swimming pool from access to the family daycare home and has all of the following characteristics:

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation LPA Cha did not observe additonal fencing that prevents access from main home to pool/jacuzzi and fencing for second window in child care area, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 11/26/2025
Plan of Correction
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Licensee will install additional fencing that prevent access to pool/jacuzzi from main home and install additonal fencing for second window and send proof to the Department by POC due date.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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:
Hanna Cha
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 11/12/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/12/2025


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
PALMDALE CC RO, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: POGHOSYAN FAMILY CHILD CARE
FACILITY NUMBER: 197700894
VISIT DATE: 11/12/2025
NARRATIVE
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Outdoor/Children’s Play Area: The children utilize the child care backyard for outdoor play enclosed with iron fencing. LPA inspected for safety, cleanliness, good repair, age-appropriate toys/equipment, and shady areas.

Pools/Bodies of Water: Per LPA observation, there is an in-ground pool and jacuzzi located in off-limits back yard area made inaccessible from child care back yard area by iron fence at 60 inches in height and no gaps or voids wider than four inches. The two iron gates maintained key locked. LPA observed a door with lock immediately left from child care front door that provides access to main home and pool/jacuzzi in back yard. LPA informed licensee that door must stay locked (Licensee provided declaration) until additional fencing is installed to prevent direct access to pool. LPA observed two windows that allow access to pool. One window was fenced with iron fencing. The second window that is located higher (above 4 feet) did not have iron fencing. LPA informed licensee that all windows must be fenced. Licensee will install fencing for second window and install additional fencing and provide proof of completion to LPA Cha by 11/26/2025. A Type B citation issued. See 809-D.

LPA did not observe an ASTM approved pool alarm or pool cover. LPA informed licensee that pool alarm or pool cover must be installed for both the pool and jacuzzi. LPA informed licensee that pool alarm must be turned on and in working order during all hours of operation. Licensee will install pool alarm or cover and provide proof to LPA Cha by 11/26/2025. A Type B citation issued. See 809-D.

LPA observed the vertical clearance from the ground to the bottom of the enclosure did not exceed two inches. LPA informed licensee that fence must be clear of all handholds or footholds that could be utilized as a climbing device. Licensee shall ensure the key lock and gate stays closed and locked at all times.

Per LPA observation, there was no life ring observed. LPA informed licensee that a US Coast Guard approved life ring with a minimum exterior diameter of 17 inches must be installed. Licensee will purchase and install life ring and send proof to LPA Cha by 11/26/2025. A Technical Violation issued.

Per LPA observation, there was a rescue pole but not a body hook installed to the pole. LPA informed licensee that a rescue pole with a fixed length of 12 feet with body hook must be installed. Licensee will purchase and install rescue pole with body hook and send proof to LPA Cha by 11/26/2025. A Technical Violation issued.

NAME OF LICENSING PROGRAM MANAGER: Mariela Ramon
NAME OF LICENSING PROGRAM ANALYST: Hanna Cha
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 11/12/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/12/2025
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
PALMDALE CC RO, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: POGHOSYAN FAMILY CHILD CARE
FACILITY NUMBER: 197700894
VISIT DATE: 11/12/2025
NARRATIVE
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LPA informed of the requirement to conduct and document daily pool checks. LPA informed licensee that the swimming pool requirements will remain in place whenever licensed care is provided, and so long as the requirements make the swimming pool inaccessible to children as determined by the licensing department.

Other: First aid kit on premises. Per Licensee, there is no smoking in the home. There is a working telephone (landline and cell phone). Per licensee, there are no weapons/firearms on the premises. The carbon monoxide and smoke alarm tested and operable.

File Review: LPA reviewed one child file which included all required documentation. LPA reviewed licensee’s file and assistant #1 file. Per record review, licensee and assistant #1(A1) Mandated Reporter training expired on 05/2025. LPA informed licensee that Mandated Reporter training must be renewed every two years. A Technical Violation issued.



Postings: Notice of Parent's Rights Poster (PUB 394), Facility License (LIC 203), Emergency Disaster Plan (LIC 610A)
Documents Provided: Entrance Checklist, Pool Regulations
To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

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.
Any duly authorized officer, employee, or agent of the Department shall, upon presentation of proper identification, shall inspect the facility. The Licensee shall permit the Department to inspect the family childcare home, and to privately interview children or staff, to determine compliance with or to prevent violations of family child care laws or regulations. Also, to enter and inspect any place providing personal care, supervision and services at any time, with or without advance notice, to secure compliance with, or to prevent a violation.
NAME OF LICENSING PROGRAM MANAGER: Mariela Ramon
NAME OF LICENSING PROGRAM ANALYST: Hanna Cha
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 11/12/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/12/2025
LIC809 (FAS) - (06/04)
Page: 6 of 7
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: POGHOSYAN FAMILY CHILD CARE
FACILITY NUMBER: 197700894
VISIT DATE: 11/12/2025
NARRATIVE
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Licensee advised of the requirement to report Unusual Incidents. Licensee informed to utilize the Unusual Incident Report/Injury Report (LIC624B) when submitting a report to the department at: www.unusualincidentreport@dss.ca.gov. A report shall be made to the department by telephone or fax during the department's normal business hours before the close of the next working day following the occurrence during the operation of family day care home. In addition, a written report shall be submitted to the department within seven (7) days following the occurrence of any events specified above.

LPA discussed safe sleep regulations and 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.

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)/ (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/.

Licensee was informed of the MyChildCarePlan.org website; 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.

During the exit interview, licensee Larisa Poghosyan confirmed that there are no Registered Sex Offenders residing in the facility.

During this inspection, three Technical Violations and two Type B citations issued. See 809-D.

A Notice of Site Visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with licensee Larisa Poghosyan.

NAME OF LICENSING PROGRAM MANAGER: Mariela Ramon
NAME OF LICENSING PROGRAM ANALYST: Hanna Cha
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 11/12/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/12/2025
LIC809 (FAS) - (06/04)
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