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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198021034
Report Date: 10/20/2022
Date Signed: 10/20/2022 11:24:40 AM

Document Has Been Signed on 10/20/2022 11:24 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: 0CENSUS: 0DATE:
10/20/2022
TYPE OF VISIT:OfficeANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Manvel Dilovyan, ApplicantTIME COMPLETED:
11:30 AM
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Licensing Program Manager (LPM) Christina Gabelman and Licensing Program Analyst (LPA) Anomeh Eivazian met with applicant, Manvel Dilovyan on 10/20/2022 at 10:30 AM in Monterey Park Regional Office. The purpose of this office meeting is for the department to go over the expectations of a licensed childcare provider. LPM Gabelman reviewed and discussed with the applicant the following Title 22 Regulations to ensure applicant will maintain compliance and meet the Title 22 regulations at all times.

Provider must reside in the home where care is being provided:

Definitions--102352 -- "Family Day Care" or "Family Child Care" means regularly provided care, protection and supervision of children, in the care giver's own home, for periods of less than 24 hours per day, while the parents or authorized representatives are away. The term "Family Child Care" supersedes the term "Family Day Care" as used in previous regulations and "Home" means the licensee's residence as defined by Government Code Section 244.

Provider must be present 80% of the time providing care as stated in the following regulation:

Operation of a Family Child Care Home--102417 (a)-- The licensee shall be present in the home and shall ensure that children in care are supervised at all times. When circumstances require the licensee to be temporarily absent from the home, the licensee shall arrange for a substitute adult to care for and supervise the children during his/her absence. Temporary absences shall not exceed 20 percent of the hours that the facility is providing care per day.



Reporting Requirements--102416.2 (a) (2)--Any change in household composition including adults moving in or out of the home and anyone living in the home who reaches his or her 18th birthday.
REPORT CONTINUES ON NEXT PAGE 1 of 3
SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Anomeh Eivazian
LICENSING EVALUATOR SIGNATURE: DATE: 10/20/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/20/2022
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 3
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: DILOVYAN FAMILY CHILD CARE
FACILITY NUMBER: 198021034
VISIT DATE: 10/20/2022
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Inspection Authority of the Department—102391 (a)--Any duly authorized officer, employee, or agent of the Department shall, upon presentation of proper identification, enter and inspect any place providing personal care, supervision, and services at any time, with or without advance notice, to secure compliance with, or to prevent a violation of, the regulations adopted by the Department governing family child care homes, and in accordance with Section 102396.

- Applicant will interact with Department staff professionally and respectfully at all times. Applicant understands that inspections are conducted in person, unannounced, and Department staff will be granted access to the facility as part of the inspection process.
- Applicant will be forthright with the department all the times to ensure the health and safety of children in care.

Overnight Care—102426-- Family Child Care Home applicant has indicated on his application that facility operation hours will be Monday to Sunday from 7:00 AM to 6 PM and 7:00 PM to 6:00 AM. Applicant is to submit written plan on how compliance with night care requirements will be met. Applicant will submit his written plan regarding Overnight Care by the end of business day 10/20/2022.

LPM Gabelman reviewed requirements for having Co-Licensee. LPM informed applicant if he decides to have a co-licensee in the future that they will need to meet the same requirements as the licensee, live in the home, have TB test clearance within a year, proof of immunization against Measles, Pertussis and Influenza, mandated reporter training certificate, preventative health and safety training and pediatric first aid and CPR certificate, criminal record clearance, updated Family Child Care Home application LIC279 and etc.

LPM also reviewed requirements for having an assistant.

Applicant submitted written declaration signed and dated on 08/22/2022 that he does not have outside employment and facility address is his only residence and does not live in another address.

LPA advised the applicant to access forms, regulations, quarterly updates and providers information notices (PIN) online at: www.ccld.ca.gov

REPORT CONTINUES ON NEXT PAGE 2 of 3
SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Anomeh Eivazian
LICENSING EVALUATOR SIGNATURE:

DATE: 10/20/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/20/2022
LIC809 (FAS) - (06/04)
Page: 2 of 3
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: DILOVYAN FAMILY CHILD CARE
FACILITY NUMBER: 198021034
VISIT DATE: 10/20/2022
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The following CCLD training videos were recommended to the applicant to view and apply to the operation of the facility.
Exit interview conducted and report was reviewed with the Applicant, Manvel Dilovyan at 11:30 AM.

REPORT END 3 of 3
SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Anomeh Eivazian
LICENSING EVALUATOR SIGNATURE:

DATE: 10/20/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/20/2022
LIC809 (FAS) - (06/04)
Page: 3 of 3