198019668-1-31-2025-33-CC-SSAN-DDFRRM-20250131121522

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198019668
Report Date: 01/31/2025
Date Signed: 01/31/2025 12:15:32 PM

Document Has Been Signed on 01/31/2025 12:15 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:	AGHAVELYAN FAMILY CHILD CARE		FACILITY NUMBER:	198019668
ADMINISTRATOR/ DIRECTOR:	NAIRA AGHAVELYAN		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(818) 241-5609
CITY:	GLENDALE	STATE: CA	ZIP CODE:	91203
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS:	DATE:	01/31/2025
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	10:29 AM
MET WITH:	Naira Aghavelyan		TIME VISIT/ INSPECTION COMPLETED:	12:30 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	Annual Inspection was conducted in Armenian. On 01/31/2025 , at 10:30 am Licensing Program Analyst (LPA) Shushanik Safaryan conducted an annual random inspection to the above facility. LPA met with Licensee, Naira Aghavelyan , to whom the reason for the visit was explained. Per Licensee, there are 7 children currently enrolled. There were 3 children present upon arrival. The licensee was observed to be operating within the license capacity limitations. All adults living in the home have obtained a criminal record clearance. This is a two story town home located on the first level. The home consists of 3 bedrooms, 2 & 1/2 bathrooms, kitchen, dining room, living room, laundry room, and front yard. Per licensee parents enter the facility through the main entrance which leads to the living room. The children use the entire first floor which consists of living room, dining room, kitchen and half bathroom. Per licensee, areas off limits to children and parents include :Entire second floor which consists of 3 bedrooms, 2 bathrooms, laundry room, and front yard. During this visit, all areas identified that are accessible for children to use were inspected for the safety, comfort, and cleanliness. At 10:30 am , Licensee guided LPA to the tour of the home. LPA was toured starting from the living room, dining room where LPA observed sofas, coffee table, and TV, children’s toys . LPA observed children tables, chairs , napping cots , 2 pack n plays. Per licensee children only use living room and dining room , where children play and sleep. LPA observed parents board next to the main entrance . LPA observed child safety gate making kitchen inaccessible to the children . LPA observed child safety latches on the kitchen cabinet under the sink .Next LPA observed child safety gate blocking stairs to the second floor and bathroom. Per licensee children don’t use the bathroom since all of them wear diapers. Page 1 of 4

SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Shushanik Safaryan
LICENSING EVALUATOR SIGNATURE:	DATE: 01/31/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/31/2025

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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

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: AGHAVELYAN FAMILY CHILD CARE	FACILITY NUMBER: 198019668
	VISIT DATE: 01/31/2025

NARRATIVE

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At 10:50 am , LPA observed the required 2A 10BC fire extinguisher indicates fully charged in the kitchen, but licensee was not able to provide receipt. Licensee stated she will purchase a new one and will send the proof to LPA. Smoke and carbon monoxide detectors in the living room were tested and are operable.
There is telephone service via a cellphone that stays at the facility during operation hours. New phone number obtained during the inspection .Hours of operation are Monday – Friday, 7:30 am – 6:00 pm. There is central air and heating in the home.
Detergents, cleaning compounds, and medications were observed to be inaccessible to children. Per Licensee, there are no poisons in the home. LPA advised that any poisons should be locked under key or combination lock. Licensee states that there are no firearms or weapons stored in the home.
All homes shall conduct fire and disaster drills at least once every six months and document the date and time of each drill. Last drill documented was conducted on 09/2024.
The home is observed to be clean and orderly. There are first aid supplies available in the kitchen . There are age-appropriate toys available for children.

Per licensee, she provides food for children in care. Licensee was advised that if food is brought from the children’s homes, all containers must be labeled with child’s name and properly stored or refrigerated.
Currently, children don’t have outdoor play time . Per licensee, parents are notified that facility does not offer outdoor play time.

At 11:00 am Licensee records were reviewed. The licensee has completed training on preventive health practices including Pediatric First Aid and CPR. The licensee's Pediatric First Aid and CPR expires on 12/2025.

LPA observed that the Licensee does have proof of Mandated Reporter AB 1207 compliant Child Care Training Certificate on file with expiration on 4/2025. www.mandatedreporterca.com

Per licensee , she has only 7 children enrolled and don’t have any assistants .
At 11:30 am children’s records were reviewed, including emergency information, and were observed to be complete. During the review , LPA observed 2 out of 6 children`s records were missing immunization records . Licensee could not locate records. Per licensee she will obtain copies and will notify LPA. Licensee states she is currently caring for 3 infants over 12 months, and they come in the different days . During the visit LPA observed 2 infants over 12 months .
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SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Shushanik Safaryan
LICENSING EVALUATOR SIGNATURE:	DATE: 01/31/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/31/2025

LIC809 (FAS) - (06/04)

Page: 2 of 5

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

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: AGHAVELYAN FAMILY CHILD CARE	FACILITY NUMBER: 198019668
	VISIT DATE: 01/31/2025

NARRATIVE

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LPA created an LIC 857, Children’s Record Review, which documents staff and children’s files reviewed during this inspection.
Per licensee, there are 2 cats in the house that stay on the second floor in off limit bedrooms.

Smoking is prohibited in a licensed Family Child Care Home. Per Licensee, no one smokes in the home.
LPA did not observe the following items during the inspection: Infant Walkers, Johnny Jumpers, Saucer Chairs, and/or any other item that fall into these categories are not permitted in a family childcare facility.

This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see PIN 22-02-CCP. 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/.

To improve the quality and value of the new inspection process, a survey will 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 tools, please send them by email 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/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.

LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource.

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SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Shushanik Safaryan
LICENSING EVALUATOR SIGNATURE:	DATE: 01/31/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/31/2025

LIC809 (FAS) - (06/04)

Page: 3 of 5

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

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: AGHAVELYAN FAMILY CHILD CARE	FACILITY NUMBER: 198019668
	VISIT DATE: 01/31/2025

NARRATIVE

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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.

LPA advised the licensee how to access forms, regulations and quarterly updates on the Child Care Licensing website at www.ccld.ca.gov.

Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain childcare by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California

During the exit interview, the LICENSEE Naira Aghavelyan , confirmed that there are no Registered Sex Offenders living in the facility.

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.

LPA discussed all the deficiencies cited during today’s inspection with the licensee. Per licensee, she understands all the deficiencies and plan of correction .

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 Naira Aghavelyan on 01/31/2025.

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SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Shushanik Safaryan
LICENSING EVALUATOR SIGNATURE:	DATE: 01/31/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/31/2025

LIC809 (FAS) - (06/04)

Page: 4 of 5

Document Has Been Signed on 01/31/2025 12:15 PM - It Cannot Be Edited

Created By: Shushanik Safaryan On 01/31/2025 at 11:37 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
, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: AGHAVELYAN FAMILY CHILD CARE	FACILITY NUMBER: 198019668
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 01/31/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

102417(g)(1)

Operation of A Family Child Care Home

(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (1) Fireplaces and open face heaters shall be screened to prevent access by children. The home shall contain a fire extinguisher and smoke detector device which meet standards established by the State Fire Marshall. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observations , records review and interview , licensee did not comply with the section cited above . LPA observed fire extinguisher in the kitchen, but licensee was not able to provide the receipt with the purchase date , which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 02/14/2025
	Plan of Correction
1 2 3 4	Licesee stated she will purchase new one and will notify LPA by POC date .

Type B

Section Cited

CCR

102418(g)

Immunizations

(g) The licensee shall document each child's immunizations as required by the California Code of Regulations, Title 17, Section 6070, and shall maintain such documentation for as long as the child is enrolled. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on records review and interview , the licensee did not comply with the section cited above. Licensee wa not able to find immunization records for 2 children files , which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 02/14/2025
	Plan of Correction
1 2 3 4	License stated , she wil obtain immunization records by POC date and will notify LPA.

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:

Brandi VanOosten

LICENSING EVALUATOR NAME:

Shushanik Safaryan

LICENSING EVALUATOR SIGNATURE:

DATE: 01/31/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/31/2025

LIC809 (FAS) - (06/04)

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