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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198021034
Report Date: 09/09/2022
Date Signed: 09/09/2022 09:09:29 AM

Document Has Been Signed on 09/09/2022 09:09 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:DILOVYAN FAMILY CHILD CAREFACILITY NUMBER:
198021034
ADMINISTRATOR:MANVEL DILOVYANFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(818) 334-7777
CITY:GLENDALESTATE: CAZIP CODE:
91206
CAPACITY: 14TOTAL ENROLLED CHILDREN: 8CENSUS: 0DATE:
09/09/2022
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
08:40 AM
MET WITH:Manvel Dilovyan, ApplicantTIME COMPLETED:
09:30 AM
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PRELICENSING INSPECTION CONDUCTED IN ARMENIAN
Licensing Program Analyst (LPA) Anomeh Eivazian conducted an announced pre-licensing follow up inspection to the above facility on 09/09/2022. LPA arrived at the facility at 8:40 AM and met with Manvel Dilovyan, Applicant who guided analyst on a tour of the facility.

The following was observed during this inspection:
1. Applicant has working landline telephone services available in the home during this inspection.
2. LPA observed a fridge in the kitchen during this inspection.
3. LPA observed the AC unit is screened and inaccessible to the children in the backyard.
4. Applicant submitted a written declaration that this address is his only resident and he does not live in another address.
5. Applicant submitted an updated application form LIC279 and updated facility operation hours and days.
6. Applicant submitted a written declaration that he does not have another outside employment and he will be present at home %80 of his daycare operation hours.

Final review of application will be completed prior to licensure.

Once licensed, the applicant is required to adhere to the terms and limitations stated on the license.

The applicant’s signature on this report acknowledges that they have signed the Application for a Family Child Care Home License (LIC 279) under the penalty of perjury that the statements on the application and any attachments are correct.

Exit interview conducted and report was reviewed with the applicant, Manvel Dilovyan at 9:30 a.m..
SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Anomeh Eivazian
LICENSING EVALUATOR SIGNATURE: DATE: 09/09/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/09/2022
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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