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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198020486
Report Date: 06/10/2021
Date Signed: 06/10/2021 10:41:40 AM

Document Has Been Signed on 06/10/2021 10:41 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:MANUKYAN FAMILY CHILD CAREFACILITY NUMBER:
198020486
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
06/10/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:40 AM
MET WITH:Tatevik Manukyan, LicenseeTIME COMPLETED:
10:50 AM
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ANNUAL INSPECTION CONDUCTED IN ARMENIAN
Licensing Program Analyst (LPA) Anomeh Eivazian conducted an unannounced annual required- 1 year inspection to the above facility on 06/10/2021. LPA arrived at the facility at 8:40 AM and met with Tatevik Manukyan, Licensee who guided analyst on a tour of the facility. Also present during this inspection, was Edik Honarchian, Licensee’s husband. Per licensee, Tatevik Manulyan facility hours are Monday to Friday from 7:00 a.m. to 5:00 p.m.

This is a one story home which consists of 2 bedrooms, 1 bathroom, kitchen, dining room, living room (FIREPLACE: inaccessible), front yard, and backyard. Per licensee at 9:10 a.m. the children use the one bedroom, living room, dining room, 1 bathroom in the hallway, and bakcyard (fenced). Per licensee areas off limits to children and parents include:1 bedroom, kitchen, front yard and off-limit areas of backyard that is separated by a gate. Note that there is a separate dwelling at the rear portion of the property (1121A Raymond Avenue, Glendale, CA 91201). During this inspection individuals who reside in the home were discussed and notes on Confidential Name List (LIC811) and attached to this report.

All areas identified on the facility sketch that are accessible for children to use were inspected for safety, comfort, and cleanliness. At 9:10 a.m., Licensee took this LPA on a tour of the home. LPA was toured through the interior starting with the living room and dining room, LPA observed sofas, a coffee table, TV, a dinging table and chairs in the living room and dining room. LPA observed the fireplace in the living room was screened to prevent access. Next LPA toured the one bedroom (daycare area) adjacent to the living room and observed children toys, cots, table and chairs in the bedroom. LPA observed all electrical outlets were covered in living room, dining room, and one daycare bedroom. Next LPA toured the one bathroom and observed all cleaning compounds, shampoos and conditioners were stores in the cabinet under the sink which is locked with the chain latch to prevent access to the children.
REPORT CONTINUES ON NEXT PAGE 1 of 4
SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Anomeh Eivazian
LICENSING EVALUATOR SIGNATURE: DATE: 06/10/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/10/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 4
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: MANUKYAN FAMILY CHILD CARE
FACILITY NUMBER: 198020486
VISIT DATE: 06/10/2021
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Next LPA toured the off-limit one bedroom and observed licensee's biological children doing zoom classes. LPA observed licensee's family members personal belongings in the home. Next LPA toured the off-limit the kitchen and observed all cleaning compounds and sharp items were inaccessible to the children. LPA observed the required 2A 10BC fire extinguisher was anchored to the wall in the kitchen. It was purchased on 06/23/2020 as read by LPA from the receipt. Licensee tested the carbon monoxide and smoke detector in the kitchen. It sounded off the alarms and heard by LPA to be functional. The licensee states that there are no poisons in the home and understands that storage areas for poisons must be locked with a key or combination lock.

Next LPA toured the backyard fenced. Currently, children are using the back yard for outdoor play time. The outdoor play area was observed to be fenced. Per licensee children will walk through the kitchen to go to the backyard to use the gates area for outdoor play. The outdoor play area was separated by children safety gate from the rest of the backyard. LPA did not observe any objects that can pose a danger to children on the outdoor yard. The licensee states that supervision is always provided.

Per Licensee, Tatevik Manukyan at 9:48 a.m there are no pets, weapons, firearms, pools, spas, hot tubs, fish ponds, or similar bodies of water on the premises.

The licensee was observed to be operating within the licensed capacity and is not exceeding the required limitations during this inspection. All adults present have obtained a criminal record clearance on Licensing Information System (LIS). Per licensee, currently she does not have any assistant.

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 06/2022 . LPA observed Licensee completed required mandated reporter training on 11/13/2019, certificate on file. There are first aid supplies available on the premises in the daycare bedroom in a closet. LPA advised licensee that if a child shows signs of illness he/she/they shall be separated from other children.

Per licensee she has not enrolled any children in her daycare since she has been licensed.
The licensee has proof of immunization against influenza, pertussis, and measles.

REPORT CONTINUES ON NEXT PAGE 2 of 4
SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Anomeh Eivazian
LICENSING EVALUATOR SIGNATURE:

DATE: 06/10/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/10/2021
LIC809 (FAS) - (06/04)
Page: 2 of 4
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: MANUKYAN FAMILY CHILD CARE
FACILITY NUMBER: 198020486
VISIT DATE: 06/10/2021
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All homes shall conduct fire and disaster drills at least once every six months, and document the date and time of each drill. Licensee has not enrolled any children in her daycare since she has been licensed.

Emergency Disaster Plan, Parent’s Rights Poster and the Facility License were observed to be posted at the wall in the daycare bedroom.

LPA did not observe the following items during the inspection: Infant Walkers, Johnny Jumpers, Saucer Chairs, Trampolines and/or any other item that fall into these categories are not permitted in a family child care facility.

Smoking is prohibited in a licensed Family Child Care Home. Per Licensee, no one smokes in the home. There is telephone service via a landline that is used and the cellphone stays at the facility during operation hours.


INFANT CARE: Licensee states that she is not currently caring for infants. Licensee states that infants will sleep in the dining room where they will constantly supervised. Appropriate sleeping arrangements and cribs was not available during this inspection. Cribs or play yard can not hinder the entrance or exit from the sleeping space, mattresses shall be firm and covered with a fitted sheet that overlaps the underside so it cannot be dislodged. Cribs and play yards is required to be free of loose articles and objects. No objects can be hanging above or attached to the side of the crib. LPA advised licensee infants can not be swaddled while in care. LPA advised the Licensee that infants shall be placed on their backs for sleeping and shall be supervised. Infants shall be checked on every 15 minutes and the time of each 15-minute check shall be documented with child’s name and date. The LIC 9227 Individual Infant Sleeping Plan shall be completed for each infant up to 12 months of age. A copy of the LIC 9227 was provided to Licensee. LPA provided the licensee with a copy of A Child Care Provider’s Guide to Safe Sleep, by American Academy of Pediatrics. LPA also consulted and explained Child Abuse Reporting, Never Shake a Baby, and Safe Sleeping practices.

REPORT CONTINUES ON NEXT PAGE 3 of 4
SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Anomeh Eivazian
LICENSING EVALUATOR SIGNATURE:

DATE: 06/10/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/10/2021
LIC809 (FAS) - (06/04)
Page: 3 of 4
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: MANUKYAN FAMILY CHILD CARE
FACILITY NUMBER: 198020486
VISIT DATE: 06/10/2021
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Medication: Incidental Medical Services (IMS) policy was discussed at 10:10 a.m. The licensee states that she will provide IMS. Per licensee, there are no children enrolled that require IMS at this time. Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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: http://www.ada.gov/childqanda.htm.

Per licensee she does not carry liability insurance or a bond in accordance with standard established by Family Child Care statue. Signed statements (LIC282) will be on children's files.

LPA advised the licensee to access forms, regulations and quarterly updates online at: www.ccld.ca.gov. LPA also discussed the Provider Information Notices (PINS) on Safe Sleep Awareness: PIN 19-02-CCP, COVID FAQ - PIN 20-11-CCP, Required Lead Testing: PIN 20-01 CCP Effects of Lead Exposure, and Guardian User Account Access - PIN 20-20-CCLD.



At this time, the licensee is in compliance with California Title 22 Regulations. Therefore, there are no citations being issued today from the areas that were inspected today.

LPA inquired into the licensee’s practices related to COVID-19. Licensee stated that they will practice hygiene such as hand washing with the children. Licensee has hand sanitizer available in the drop off area and inside her home. Licensee states they will practice social distancing with children, take children temperature daily, licensee and staff will wear masks all the times and teaching children about wearing proper face covering.

Exit interview was conducted with Licensee, Tatevik Manukyan at 10:50 a.m.. Appeal rights explained & provided. A copy of this report and all other Licensing reports must be made available to the public for 3 years.
REPORT END 4 of 4
SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Anomeh Eivazian
LICENSING EVALUATOR SIGNATURE:

DATE: 06/10/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/10/2021
LIC809 (FAS) - (06/04)
Page: 4 of 4