198018378-7-2-2025-33-CC-SSAN-DJ7VBT-20250702161805

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198018378
Report Date: 07/02/2025
Date Signed: 07/02/2025 04:18:09 PM

Document Has Been Signed on 07/02/2025 04:18 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:	BAROYAN FAMILY CHILD CARE		FACILITY NUMBER:	198018378
ADMINISTRATOR/ DIRECTOR:	BAROYAN, HAYKANUSH		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(818) 568-6848
CITY:	GLENDALE	STATE: CA	ZIP CODE:	91206
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS: 5	DATE:	07/02/2025
TYPE OF VISIT:	Case Management - Deficiencies	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	02:00 PM
MET WITH:	Haykanush Baroyan		TIME VISIT/ INSPECTION COMPLETED:	03:30 PM

NARRATIVE

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On 07/02/2025, Licensing Program Analyst (LPA) Shushanik Safaryan conducted Case- management deficiency visit to the above facility. Upon arrival, at 2:00 pm , LPA met with the Haykanush Baroyan. The purpose of the visit was explained, and a tour of the facility was conducted .Licensee`s mother Azatuhi Baroyan was also present .
During the tour , LPA observed 5 children upon arrival. LPA noted that the licensee`s bedroom , which is adjacent to the day care room , has access to the pool through sliding doors located in the bedroom. LPA observed door alarm and child safety latch on the bedroom door. In the bedroom , LPA observed cabinets in front of the sliding door leading to the pool. Additionally, LPA observed detached garage located in the outdoor play area, which had a side door with access to the pool. Per licensee, garage door can not open from outside only from inside of the garage. LPA observed side door has a key lock and door alarm. on the garage side door.
LPA discussed with the licensee the regulatory requirements regarding an enclosure, including, but not limited to, a fence, wall, or other barrier that isolates the swimming pool from access to the family day care home.

Based on the LPA’s observations and records review, the following deficiencies listed on the attached LIC 809D (deficiency page) are being cited in accordance with California Code of Regulations Title 22. Deficiencies that are being cited need to be cleared to protect the children’s health & safety.

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 the licensee Haykanush Baroyan on 07/02/2025.

Licensee refused to sign the report .

End of page

NAME OF LICENSING PROGRAM MANAGER: Brandi VanOosten
NAME OF LICENSING PROGRAM ANALYST: Shushanik Safaryan
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 07/02/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/02/2025

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 07/02/2025 04:18 PM - It Cannot Be Edited

Created By: Shushanik Safaryan On 07/02/2025 at 02:27 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: BAROYAN FAMILY CHILD CARE	FACILITY NUMBER: 198018378
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 07/02/2025

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 07/03/2025 Section Cited HSC 1596.814(a)(1)	1 2 3 4 5 6 7	1596.814(a)(1 (A) Family daycare home; in-ground swimming pool 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.	1 2 3 4 5 6 7	Licensee is not agree with the citation and refuse to sign the report and deficiency page.
	8 9 10 11 12 13 14	LPA noted that the licensee`s bedroom , which is adjacent to the living room (day care are), has access to the pool through sliding doors located in the bedroom. Additionally, LPA observed detached garage located in the outdoor play area, which had a side door with access to the pool.	8 9 10 11 12 13 14
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

	Brandi VanOosten
NAME OF LICENSING PROGRAM MANAGER:

	Shushanik Safaryan
NAME OF LICENSING PROGRAM ANALYST:

LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 07/02/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/02/2025

LIC809 (FAS) - (06/04)

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