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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198003947
Report Date: 11/21/2024
Date Signed: 11/21/2024 03:25:05 PM

Document Has Been Signed on 11/21/2024 03:25 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
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:A.R.S.NAIRY DAY CARE CENTERFACILITY NUMBER:
198003947
ADMINISTRATOR/
DIRECTOR:		BARSEGYAN, LILITFACILITY TYPE:
850
ADDRESS:505 N. MORRIS PL.TELEPHONE:
(323) 887-1636
CITY:MONTEBELLOSTATE: CAZIP CODE:
90640
CAPACITY: 30TOTAL ENROLLED CHILDREN: 12CENSUS: 8DATE:
11/21/2024
TYPE OF VISIT:POCUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:06 PM
MET WITH:Lilit BarsegyanTIME VISIT/
INSPECTION COMPLETED:
03:40 PM
NARRATIVE
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At 02:06 pm Licensing Program Analyst (LPA) Veronica Martinez Garza conducted an unannounced POC (Plan of correction) inspection to ensure the Type B deficiencies cited on 10/09/24 have been cleared. LPA met with director Lilit Barsegyan. Census was taken. The following was observed:

- Staff 1 (S1) and S2 are missing LIC 503.
- S1 is missing proof of immunizations (MMR, Tdap, TB, and Flu).
- S1 has a completed LIC 9052 and LIC 501. LPA cleared deficiencies and issued a POC clearance letter.

The following deficiencies were cited in accordance with Title 22 of the California Code of Regulations and Health & Safety Codes. Please see 809D for documentation of deficiencies.

A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.



Exit interview conducted and report was reviewed with director Lilit Barsegyan.




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SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Veronica Martinez-Garza
LICENSING EVALUATOR SIGNATURE: DATE: 11/21/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/21/2024
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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Document Has Been Signed on 11/21/2024 03:25 PM - It Cannot Be Edited


Created By: Veronica Martinez-Garza On 11/21/2024 at 02:50 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
, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: A.R.S.NAIRY DAY CARE CENTER
FACILITY NUMBER: 198003947

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/21/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
12/20/2024
Section Cited
CCR
101216(g)(1)

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(1) Except as specified in (3) below, good physical health shall be verified by a health screening, including a test for tuberculosis, performed by or under the supervision of a physician not more than one year prior to or seven days after employment or licensure.

This requirement is not met as evidenced by:
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Per director, S1 and S2 proof of LIC 503 will be submitted to LPA by POC due date.
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LPA observed staff 1 (S1) and S2 do not have a complete LIC 503
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Type B
12/20/2024
Section Cited
CCR1596.7995(a)(1)

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(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:
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Per director, proof of immunizations will be submitted to LPA by POC due date.
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Staff 1 (S1) is missing proof of immunizations.
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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.
SUPERVISOR'S NAME:Ana Chico
LICENSING EVALUATOR NAME:Veronica Martinez-Garza
LICENSING EVALUATOR SIGNATURE:
DATE: 11/21/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/21/2024


LIC809 (FAS) - (06/04)
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