198020224-8-26-2024-33-CC-SSAN-D8HTSL-20240826145919

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198020224
Report Date: 08/26/2024
Date Signed: 08/26/2024 02:59:29 PM

Document Has Been Signed on 08/26/2024 02:59 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:	KHANJYAN & GABRIELYAN FAMILY CHILD CARE		FACILITY NUMBER:	198020224
ADMINISTRATOR/ DIRECTOR:	H.KHANJYAN & A.GABRIELYAN		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(818) 445-3139
CITY:	LA CRESCENTA	STATE: CA	ZIP CODE:	91214
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS: 0	DATE:	08/26/2024
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	01:46 PM
MET WITH:	Alis Gabrilelyan		TIME VISIT/ INSPECTION COMPLETED:	03:30 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	On 08/26/24, at 01:45 pm ,Licensing Program Analyst (LPA) Shushanik Safaryan conducted an annual random inspection to the above facility. LPA met with one of the Licensee`s , Alis Gabrielyan, to whom the reason for the visit was explained. Per Licensee, there are 13 children currently enrolled. There were no children present during the inspection. Family members residing in the home are 4 adults (criminal record clearances on file). This is a one-story home which consists of 2 bedrooms, 1 bathroom, kitchen, dining room, living room, converted garage, living structure and backyard (fenced). The children use the bathroom, the living room, the dining room, and the backyard(fenced). Per licensee, areas off limits to children include: all bedrooms, kitchen, converted garage, living area in the backyard. Per Licensee her brother will reside in the converted garage, LPA reminded licensee anyone over 18 need to submit fingerprints and form was provided, Areas accessible to children were inspected to ensure that they are clean and orderly with ventilation and heating for safety and comfort. There were safe toys, play equipment and materials observed for children. There is a working telephone service maintained in the home. Detergents, cleaning compounds, medications, and other items which can pose a danger to children are made inaccessible. Licensee states that there are no poisons in the home. The licensee does understand that poison must be locked with a key or combination lock. Facility License, Emergency Disaster Plan, Parent’s Rights Poster, and Earthquake Preparedness Checklist were observed to be posted in the front entrance . A current children’s roster was available for review. There is telephone service via a cellphone that stays at the facility during operation hours. Hours of operation are Monday – Friday, 08:00am – 4:30 pm. There is central air and heating in the home. Licensee states that there are no firearms or weapons stored in the home. Page 1 of 3

SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Shushanik Safaryan
LICENSING EVALUATOR SIGNATURE:	DATE: 08/26/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/26/2024

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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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: KHANJYAN & GABRIELYAN FAMILY CHILD CARE	FACILITY NUMBER: 198020224
	VISIT DATE: 08/26/2024

NARRATIVE

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The valve on the required 2A 10BC fire extinguisher indicates fully charged and LPA observed receipt with a purchase date of 01/30/24. Smoke and carbon monoxide detectors were tested and are operable.

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 07/2024.

The home is observed to be clean and orderly. There are first aid supplies available. 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 are using the backyard for outdoor play time. The outdoor play area was observed to be fenced and gated. LPA observed that the outdoor yard has toys and other materials for children to play with. LPA did not observe any objects that can pose danger to children. No bodies of water were observed on this day.
Licensee and staff records were reviewed. The licensee and co-licensee have completed training on preventive health practices including Pediatric First Aid and CPR. The licensee's and Co-Licensee`s Pediatric First Aid and CPR expires on 08/01/2026.

LPA observed that the Licensee and Co-licensee does have proof of Mandated Reporter AB 1207 compliant Child Care Training Certificate on file with expiration on 02/26. www.mandatedreporterca.com

Children’s records were reviewed, including emergency information and were observed to be complete. Licensee states she is currently not caring for infants. LPA created an LIC 857, Children’s Record Review.
Per licensee, there are no animals on the premises.
Smoking is prohibited in a licensed Family Child Care Home. Per Licensee, no one smokes in the home.
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SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Shushanik Safaryan
LICENSING EVALUATOR SIGNATURE:	DATE: 08/26/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/26/2024

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: KHANJYAN & GABRIELYAN FAMILY CHILD CARE	FACILITY NUMBER: 198020224
	VISIT DATE: 08/26/2024

NARRATIVE

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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.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. 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/.

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.

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 Alis Gabrielyan confirmed that there are no Registered Sex Offenders living in the facility .

Currently, the licensee is in compliance with California Code of Regulations Title 22. No deficiencies cited.

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 , Alis Gabrielyan on 08/26/24.
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SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Shushanik Safaryan
LICENSING EVALUATOR SIGNATURE:	DATE: 08/26/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/26/2024

LIC809 (FAS) - (06/04)

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