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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197750140
Report Date: 12/03/2025
Date Signed: 12/03/2025 04:36:26 PM

Document Has Been Signed on 12/03/2025 04:36 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:HAYKAZUNYADZ CHILD CARE INC.FACILITY NUMBER:
197750140
ADMINISTRATOR/
DIRECTOR:		ZOVIG INJEJIKIANFACILITY TYPE:
850
ADDRESS:11329 VALERIO STREETTELEPHONE:
(818) 522-4172
CITY:SUN VALLEYSTATE: CAZIP CODE:
91352
CAPACITY: 53TOTAL ENROLLED CHILDREN: 53CENSUS: DATE:
12/03/2025
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:00 AM
MET WITH:TIME VISIT/
INSPECTION COMPLETED:
04:50 PM
NARRATIVE
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On Wednesday, December 3, 2025 at 10:10 am, Licensing Program Analyst (LPA) Evelyn Garcia conducted an unannounced annual inspection and met with Facility Representative, Knarik Martirosyan and Arman Pirijianyan (director’s son) who guided LPA Garcia on a tour of the facility. This is a preschool program that serves children ages 2 to 5 years old. This program operates Monday to Friday 8:00am – 6:00pm. Sign in and out takes place at the entrance of the facility. All areas identified on the facility sketch were toured and inspected both indoors and outdoors. Teacher and child ratio were observed, and present staff are fingerprinted cleared, however there was only 1 fully qualified teacher and no qualified aides that could be verified by documentation during the inspection. 1 Type A violation has been issued. Please see 809-D for more information. Upon arrival, there were 41 children present, 8 staff providing care and supervision.

LPA entered the TK Classroom, which serves children 4-5 years of age. There were 18 children present and 2 staff in this classroom as LPA Garcia toured. LPA observed age-appropriate furniture and equipment to be in good condition, free of sharp, not loose, or pointed parts and age-appropriate toys accessible to children. LPA observed cubbies for children to store their personal belongings. Cleaning supplies were not observed to be stored in the classroom. Adjacent to the classroom, there is restroom that is utilized by the children in this classroom. LPA observed the restroom that had 2 toilets and 2 hand washing sinks. LPA Garcia observed a trash bin with a tight lid.

NAME OF LICENSING PROGRAM MANAGER: Mariela Ramon
NAME OF LICENSING PROGRAM ANALYST: Evelyn Garcia
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 12/03/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/03/2025
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.

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Document Has Been Signed on 12/03/2025 04:36 PM - It Cannot Be Edited


Created By: Evelyn Garcia On 12/03/2025 at 02:33 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: HAYKAZUNYADZ CHILD CARE INC.
FACILITY NUMBER: 197750140

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/03/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101174(a)
Disaster and Mass Casualty Plan
(a) Each licensee shall have a disaster and mass casualty plan of action. The plan shall be in writing and shall be readily available.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, interview, record review, the licensee did not comply with the section cited above which poses/posed a potential health, safety or personal rights risk to persons in care. LPA Garcia did not observe emergency disaster plan and Site designee stated that they could not locate their emergency disaster plan, however it was submitted when completing application.
POC Due Date: 12/04/2025
Plan of Correction
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Site Director will submit current emergency disaster drill log and send a copy to the department to be filed. Site director will post the emergency disaster plan and send proof LPA.
Type B
Section Cited
HSC
1596.7995(a)(1)
General Provisions and Definitions
(1) Commencing September 1, 2016, a person shall not be employed or volunteer at a day care center if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, interview, record review, the licensee did not comply with the section cited above which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 12/10/2025
Plan of Correction
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SIte director will review all staff files and ensure each staff member has TB, MMR, TDAP, FLU/ FLU declination and send proof to LPA and place copy in each staffs file for review for the department.
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:
Evelyn Garcia
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 12/03/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/03/2025


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Document Has Been Signed on 12/03/2025 04:36 PM - It Cannot Be Edited


Created By: Evelyn Garcia On 12/03/2025 at 02:51 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: HAYKAZUNYADZ CHILD CARE INC.
FACILITY NUMBER: 197750140

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/03/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
101216.1(c)(1)
Teacher Qualifications and Duties
(c) To be a fully qualified teacher, a teacher shall have one of the following: (1) Twelve postsecondary semester or equivalent quarter units in early childhood education or child development completed, with passing grades, at an accredited or approved college or university; and at least six months of work experience in a licensed child care center or comparable group child care program.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, interview, record review, the licensee did not comply with the section cited above which poses an immediate health, safety or personal rights risk to persons in care. LPA Garcia observed Hasmik Jilavyan, Armine Margaryan, Miriam Martirosyan to not have qualifications during the inspection. When speaking with "director" Arman Pirijianyan, he stated that aides were considered workers and not teachers.
POC Due Date: 12/04/2025
Plan of Correction
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Facility representative informed LPA Garcia that they will pull other qualified teachers from another center to come fill in for the teachers that were not qualified and send proof of qualifications to LPA Garcia within 24 hours.
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:
Evelyn Garcia
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 12/03/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/03/2025


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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: HAYKAZUNYADZ CHILD CARE INC.
FACILITY NUMBER: 197750140
VISIT DATE: 12/03/2025
NARRATIVE
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LPA entered the Butterfly Classroom, which serves children 3-4 years of age. There were 16 children present and 2 staff in this classroom as LPA Garcia toured. LPA observed age-appropriate furniture and equipment to be in good condition, free of sharp, not loose, or pointed parts and age-appropriate toys accessible to children. LPA observed cubbies for children to store their personal belongings. Cleaning supplies were not observed to be stored in the classroom. LPA Garcia observed a trash bin with a tight lid.

LPA entered the Lady Bug Classroom, which serves children 2-3 years of age. There were 7 children present and 2 staff in this classroom as LPA Garcia toured. LPA observed age-appropriate furniture and equipment to be in good condition, free of sharp, not loose, or pointed parts and age-appropriate toys accessible to children. LPA observed cubbies for children to store their personal belongings. Cleaning supplies were not observed to be stored in the classroom. Adjacent to the classroom, there is restroom that is utilized by the children in the butterfly and lady bugs classroom. LPA observed 3 toilets and 3 hand washing sinks. LPA Garcia observed a trash bin with a tight lid.

Heating, lighting and ventilation were evaluated by LPA Garcia. LPA observed central Heating and A/C units on located in each classroom. LPA observed the temperature of the classrooms to be comfortable to the children. LPA observed fire extinguishers located in each classroom. The valve for the fire extinguisher on the required 2-A-10BC fire extinguishers indicating fully charged and serviced on 7/23/25. The carbon monoxide detectors and smoke detectors were tested during this visit and LPA heard sounds and are operable. The last emergency drill was conducted on 10/6/25. LPA observed napping equipment (cots) to be in good condition and stored in the daycare storage room. First aid kit supplies are kept inside the classrooms, out of reach to the children. LPA observed the kits to be fully equipped. During this visit, per Site designee, Knarik Martirosyan, stated there are currently no children with medication nor with food allergies enrolled. LPA Garcia asked if there were any poisons, firearms, weapons or bodies of water. Site designee stated no firearms, weapons, or poisons, nor are there bodies of water. LPA did not observe firearms or weapons, poisons, nor bodies of water. Site designee stated the ill isolation area takes place in the Site Director’s office and children utilize staff restroom.

There are 2 restrooms located in this facility. One is located in the TK classroom. The other is located in the Lady Bug classroom and are shared with the Butterfly classroom. LPA Garcia observed the restrooms to be in good condition with working toilets, sinks, hand soap dispenser and paper towels.

NAME OF LICENSING PROGRAM MANAGER: Mariela Ramon
NAME OF LICENSING PROGRAM ANALYST: Evelyn Garcia
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 12/03/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/03/2025
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 CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: HAYKAZUNYADZ CHILD CARE INC.
FACILITY NUMBER: 197750140
VISIT DATE: 12/03/2025
NARRATIVE
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 LPA observed a total of 5 toilets and 5 hand washing sinks utilized by the children. There is 1 staff restroom in this facility.

LPA Garcia entered the outdoor play area. The outdoor play area is surrounded by an iron gate with mesh placed over it and observed the equipment to be in a safe condition, free of sharp, no loose or pointed parts. The surface of the outdoor activity space (concrete, poured in rubber, brick) is maintained in a safe condition and is free of hazards. LPA Garcia observed play structure and equipment to be age-appropriate for ages 2-5 years and areas around or under high climbing equipment, are cushioned with poured in rubber and artificial turf that may absorb a fall. For adequate shade, LPA Garcia observed 2 hip roof shade canopies. LPA observed the playground yard to be fenced and gates that leads to the parking lot are closed and locked with a hinge lock that is inaccessible to the children. For outdoor water drinking, staff bring out the children’s individual water bottles.

This program provides meals and snacks for the children, and the meals are delivered on a daily basis. LPA Garcia informed Site designee that any food brought from the children's homes, the container shall be labeled with the child's name and properly stored or refrigerated. This facility does not utilize a kitchen as meals are delivered straight to the classroom from the food vendor. Menus were posted in the office and classrooms. Lead testing was conducted and there was no exceedance. This facility drinks water from filtered water system. Water bottles are used and brought from home or provided by parents.

The following documents were posted in a prominent, publicly accessible area at the facility: Facility License, Menu, Daily Schedule. The following documents were not observed to be posted: Notification of Parents' Rights (PUB 393), Personal Rights (LIC 613A), and Earthquake Preparedness (LIC 9148), Emergency Disaster Plan (LIC 610) and. LPA Garcia observed sign in/out sheets and observed 32 signatures with 41 children present. LPA explained to site designee the importance of having parents sign each child in and out each day.

LPA Garcia reviewed the children’s roster, children’s files and staff files and observed the children’s files to be complete.

NAME OF LICENSING PROGRAM MANAGER: Mariela Ramon
NAME OF LICENSING PROGRAM ANALYST: Evelyn Garcia
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 12/03/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/03/2025
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 CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: HAYKAZUNYADZ CHILD CARE INC.
FACILITY NUMBER: 197750140
VISIT DATE: 12/03/2025
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LPA Garcia observed a 1 staff Pediatric First Aid/CPR certification dated 9/19/25, Preventative Health and Safety certification for site director dated, 6/3/22. Director has proof of immunization against Pertussis, MMR and Influenza. Director has completed the mandated reporter (AB 1207) training dated 10/7/24. Director was advised that the mandated reporter training must be completed every 2 years, and is available at www.mandatedreporterca.com

Items discussed during this visit:

1. The following items are prohibited by Licensing: 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. Breakfast/Lunch/Snack Menus: Menus are required to be posted one week in advance where it is visible by the child's authorized representative. Menus for the past 30 days must also be available upon request.

3. Current Children’s Roster: Each childcare facility shall maintain a current roster of children who are provided care in the facility. The roster shall include the name, address, and daytime telephone number of the child's parent or guardian, and the name and telephone number of the child's physician. This roster shall be available to the licensing agency upon request.

4.LIC 311A - Records to be Maintained at the Facility: LPAs advised that forms, regulations and quarterly updates can be accessed on the Child Care Licensing website at: www.ccld.ca.gov.

5.Pediatric First Aid and CPR: At least one person trained in Pediatric First Aid and CPR and EMSA approved must be present.

6.Designated Staff: The name of the childcare center director or fully qualified teacher(s) designated to act in the director's absence must be on file.

NAME OF LICENSING PROGRAM MANAGER: Mariela Ramon
NAME OF LICENSING PROGRAM ANALYST: Evelyn Garcia
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 12/03/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/03/2025
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 CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: HAYKAZUNYADZ CHILD CARE INC.
FACILITY NUMBER: 197750140
VISIT DATE: 12/03/2025
NARRATIVE
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7.Qualifications: Educational background, training, and/or experience for each staff present must be available for review

8. Immunization Requirements: Commencing September 1, 2016, a person shall not be employed or volunteer at a day care center if he or she has not been immunized against influenza, pertussis, and measles or influenza declination

9.Children’s Records: must be available for review; including but not limited to, the following: Name, address and telephone number of the child's authorized representative and of relatives or others who can assume responsibility for the child if the authorized representative cannot be reached when necessary.

Criminal Record Clearance - Licensee [or facility representative] was reminded that all adults 18 and over, 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 Child

Care Center. 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.

Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test.

For child care center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1CCP).LPA verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP.LPA referred licensee facility representative to the Department website for lead: Lead Toxicity Prevention and Water Testing Information.

NAME OF LICENSING PROGRAM MANAGER: Mariela Ramon
NAME OF LICENSING PROGRAM ANALYST: Evelyn Garcia
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 12/03/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/03/2025
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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: HAYKAZUNYADZ CHILD CARE INC.
FACILITY NUMBER: 197750140
VISIT DATE: 12/03/2025
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Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02CCP. When any IMS is provided, an updated Plan of Operation that includes 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 are available at: https://www.ada.gov/resources/child-care-centers/.

Facility representative 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.

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.

Deficiencies:

1)Type A Violation- Non-qualified staff providing care and supervision. 2)Type B Violation - Emergency Disaster plan not posted. 3)Type B Violation – Incomplete immunization records for staff

LPA Evelyn Garcia informed facility representative Knarik Martirosyan that this report dated 12/3/2025 documents one Type A citation which shall be posted for 30 consecutive days as there is/are immediate risk(s) to the health, safety, or personal rights of children in care. Also, LPA Evelyn Garcia informed the facility representative, Knarik Martirosyan, to provide a copy of this licensing report dated, 12/3/2025 that documents any Type A citation(s) to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

Notice of Site Visit - A notice of site visit was given and must remain posted for 30 days. Failure to maintain posting as required will result in a $100.00 civil penalty.

Exit interview conducted and report was reviewed with Facility Representative, Knarik Martirosyan.

NAME OF LICENSING PROGRAM MANAGER: Mariela Ramon
NAME OF LICENSING PROGRAM ANALYST: Evelyn Garcia
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 12/03/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/03/2025
LIC809 (FAS) - (06/04)
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