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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198021034
Report Date: 01/29/2024
Date Signed: 01/29/2024 02:53:10 PM

Document Has Been Signed on 01/29/2024 02:53 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
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:DILOVYAN FAMILY CHILD CAREFACILITY NUMBER:
198021034
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 7DATE:
01/29/2024
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
12:20 PM
MET WITH:Manvel Dilovyan, LicenseeTIME COMPLETED:
03:15 PM
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CASE MANAGEMENT INSPECTION CONDUCTED IN ARMENIAN
Licensing Program Analysts (LPA) Anomeh Eivazian and Jessica Hopkins Hernandez conducted an unannounced case- management licensee initiated inspection to the above facility on 01/29/24 due to licensee is requesting capacity increase. LPAs arrived at the facility at 12:20 PM and met with Ida Hakobyan, Licensee's assistant. Upon LPAs arrival to the facility licensee was not present in the home. At 12:45 p.m., Manvel Dilovyan arrived to the facility who stated he went to a Doctor appointment. Licensee guided analysts on a tour of the facility. A COVID 19 risk assessment was conducted prior to entering the facility. Per licensee, Manvel Dilovyan facility hours are Monday to Sunday from 12:00 a.m. to 11:58 p.m. Fire Clearance for Large Family Child Care Home was granted on 01/26/24.

This is a one story home located on the first level. The home consists of 3 bedrooms, 2 restrooms, living room, dining room, kitchen, laundry room, garage, storage attached to garage, front yard, and backyard (fenced). Per licensee the children use the Master bedroom, bathroom in the master bedroom, living room, dining room (daycare classrooms), two bedrooms as infant nap areas, kitchen, and backyard (fenced). Per licensee areas off limits to children and parents include: One bathroom adjacent to the kitchen, front yard, storage in the backyard, and garage. Per licensee, parents enter the home through the main entrance door which leads to the living room. Per licensee, children only walk through the kitchen and laundry room to go to the backyard. 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 12:25 p.m., Licensee's assistant, Ida Hakobyan took this LPAs on a tour of the home. LPAs observed one child was in the living room awake and playing, four children were napping on the bed and one infant was napping in the pack n'play in the master bedroom while the master bedroom door was closed and one infant was napping in the bedroom adjacent to the kitchen in the pack n' play while the bedroom door was closed. At 12:45 p.m., when licensee arrived to the home guided LPAs through the tour of
REPORT CONTINUES ON NEXT PAGE 1 of 5
SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Anomeh Eivazian
LICENSING EVALUATOR SIGNATURE: DATE: 01/29/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/29/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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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
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: DILOVYAN FAMILY CHILD CARE
FACILITY NUMBER: 198021034
VISIT DATE: 01/29/2024
NARRATIVE
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the home. LPAs toured the living room and dining room and observed children tables, chairs and toys in the living room and dining room. Next LPAs toured the master bedroom and observed six beds and one pack n' play in the master bedroom. Next LPAs toured the children bathroom in the master bedroom and did not observe any hazards. Next LPAs toured the one bedroom adjacent to the master bedroom and observed a bed and pack n'play in the bedroom. LPA's observed a child safety gate was installed to the kitchen. Next LPAs toured the one bedroom adjacent to the kitchen and observed a pack n' play and a bed in the bedroom. Per licensee, he uses the two bedrooms for napping infants only. LPAs observed the required 2A 10BC fire extinguisher was anchored to the wall in the living room. Per licensee, it was purchased for pre licensing inspection and has not been serviced annually as it is required. Licensee tested the carbon monoxide and smoke detectors in the living room. It sounded off the alarms and heard by LPA to be functional. Detergents, cleaning compounds, medications, and other items which could pose a danger to children were observed to be inaccessible to children.

Next LPAs toured the backyard fenced. Currently, children are using the back yard for outdoor play time. The outdoor play area was observed to be fenced. LPAs observed that the outdoor yard has toys and other materials for children to play with. 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, he 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. Per Licensee, Manvel Dilovyan at 1:00 p.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 not to be operating within the licensed capacity and is exceeding the required limitations during this inspection with one child. During this inspection there were seven children present in the home, two being infants and four under six year old. All adults present have obtained a criminal record clearance on Licensing Information System (LIS). Per licensee, currently he has two assistants. Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, 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 up to $500.00 maximum per day/per person will be assessed if this regulation is violated.
REPORT CONTINUES ON NEXT PAGE 2 of 5
SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Anomeh Eivazian
LICENSING EVALUATOR SIGNATURE:

DATE: 01/29/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/29/2024
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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
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: DILOVYAN FAMILY CHILD CARE
FACILITY NUMBER: 198021034
VISIT DATE: 01/29/2024
NARRATIVE
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The licensee and other personnel have completed training on preventive health practices including Pediatric First Aid and CPR. The licensee's Pediatric First Aid and CPR expires on 04/24 and Ida Hakobyan pediatric First Aid and CPR expires 10/25. Licensee, Manvel Dilovyan completed required mandated reporter training on 03/28/22. There are first aid supplies available on the premises in the living room. LPA advised licensee that if a child shows signs of illness he/she/they shall be separated from other children.

At 1:00 p.m., facility roster was reviewed and completed. Per licensee currently there are 8 children enrolled. LPA reviewed 6 children's records, including emergency information from 8 enrolled children, and all 6 reviewed files were completed. The licensee and her assistant, Ida Hakobyan have proof of immunization against influenza, pertussis, and measles.

All homes shall conduct fire and disaster drills at least once every six months, and document the date and time of each drill. Per licensee, he has not conduct any fire drill with children since he has been licensed.
Emergency Disaster Plan, Parent’s Rights Poster and the Facility License were observed to be posted at the wall in the living room.

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. Per licensee she does not carry liability insurance or a bond in accordance with standard established by Family Child Care statue. Signed statements (LIC282) on 6 reviewed files.

SAFE SLEEP: LPA discussed the safe sleep regulations with licensee, and discussed the Child Care Licensing Safe Sleep webpage at http://www.cdss.ca.gov/inforescources/child-care-licensing/public-information-and-resoucrces/safe-sleep as an additional resource. LPA also informed licensee of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at http://www/cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment. Boppy recall: https://www.cpsc.gov/Recalls/2021/The-Boppy-Company-Recalls-Over-3-Million-Original-Newborn-Loungers-Boppy-Preferred-Newborn-Loungers-and-Pottery-Barn-Kids-Boppy-Newborn-Loungers-After-8-Infant-Deaths-Suffocation-Risk
REPORT CONTINUES ON NEXT PAGE 3 of 5
SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Anomeh Eivazian
LICENSING EVALUATOR SIGNATURE:

DATE: 01/29/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/29/2024
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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
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: DILOVYAN FAMILY CHILD CARE
FACILITY NUMBER: 198021034
VISIT DATE: 01/29/2024
NARRATIVE
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INFANT CARE: Licensee states that he provides care to infants and currently there are two infants enrolled in the daycare. Licensee states that infants sleep in the bedrooms. During this inspection LPAs observed one infant was napping in the master bedroom in the pack n' play and one infant was napping in the bedroom adjacent to the kitchen with the bedroom doors closed. LPA informed licensee while infants are napping in the bedrooms the bedroom doors can not be closed. Appropriate sleeping arrangements and cribs were observed. (one crib for each infant in care was observed). Cribs or play yard did not hinder the entrance or exit from the sleeping space in the bedrooms, mattresses were firm and covered with a fitted sheet. Cribs and play yards were observed to be free of loose articles and objects. No objects were observed to be hanging above or attached to the side of the crib. LPA did not observe any infants 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 was observed in two enrolled infants files. LPAs did not observe napping chart for two present infants. Per licensee, they check on napping infants all the times and one person is sitting in the rooms when children are napping. LPA advised licensee that napping chart is required to be completed every 15-mintues for each napping infant.

Medication: Incidental Medical Services (IMS) policy was discussed. The licensee states that she will provide IMS. Per licensee, there are no children enrolled that require IMS at this time. 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.

LPA advised the licensee to access forms, regulations and quarterly updates online at: www.ccld.ca.gov.
REPORT CONTINUES ON NEXT PAGE 4 of 5
SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Anomeh Eivazian
LICENSING EVALUATOR SIGNATURE:

DATE: 01/29/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/29/2024
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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
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: DILOVYAN FAMILY CHILD CARE
FACILITY NUMBER: 198021034
VISIT DATE: 01/29/2024
NARRATIVE
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LPA Anomeh Eivazian informed licensee, Manvel Dilovyan that this report dated 01/29/24 document(s) 1 of Type A citation. Type A citation(s) which shall be posted for 30 consecutive days as there is immediate risk(s) to the health, safety, or personal rights of children in care.

Also, LPA Anomeh Eivazian informed the licensee, Manvel Dilovyan to provide a copy of this licensing report dated 01/29/24 that documents any Type A citation(s) to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

The Notice of Site Visit (LIC 9213) 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, Manvel Dilovyan at 3:15 p.m..
REPORT END 5 of 5
SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Anomeh Eivazian
LICENSING EVALUATOR SIGNATURE:

DATE: 01/29/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/29/2024
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Document Has Been Signed on 01/29/2024 02:53 PM - It Cannot Be Edited


Created By: Anomeh Eivazian On 01/29/2024 at 02:05 PM
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: DILOVYAN FAMILY CHILD CARE
FACILITY NUMBER: 198021034

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/29/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
01/30/2024
Section Cited
CCR
102416.5(a)

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102416.5 (a)Staffing Ratio and Capacity (a) The capacity specified on the license shall be the maximum number of children for whom care may be provided at any one time.
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Per licensee, he will disenroll one child effective 01/30/24 and a copy of updated roster will be emailed to LPA by 01/30/24.
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On 01/29/24 LPAs observed seven children were present in the home, two being infants. Licensee was observed to be out of ratio with one child.
This poses an immediate health, safety and personal right risk to the children in care.
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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:Christina Gabelman
LICENSING EVALUATOR NAME:Anomeh Eivazian
LICENSING EVALUATOR SIGNATURE:
DATE: 01/29/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/29/2024


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Document Has Been Signed on 01/29/2024 02:53 PM - It Cannot Be Edited


Created By: Anomeh Eivazian On 01/29/2024 at 02:11 PM
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: DILOVYAN FAMILY CHILD CARE
FACILITY NUMBER: 198021034

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/29/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/09/2024
Section Cited
CCR
102417(g)(9)(A)

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102417(g)(9)(A)-- Operation of a Family Child Care Home-- Each family child care home shall conduct fire drills and disaster drills at least once every six months.
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Per licensee, he will conduct a fire drill by plan of correction due date and a copy of drill log will be emailed to LPA.
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Per licensee, he has not conduct a fire drill since he has been licensed.
This poses a potential health, safety and personal right risk to the children in care.
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Type B
02/09/2024
Section Cited
CCR102417(g)(1)

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102417(g)(1)-- Operation of a Family Child Care Home--Fireplaces and open-face heaters shall be screened to prevent access by children. The home shall contain a fire extinguisher and smoke etc...This requirement was not met as evidenced by...
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Per licensee, she will service the fire extinguisher by plan of correction due date and a copy of service tag will be submitted to LPA.
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Per licensee, he has not serviced fire extinguisher annually as it is required.

This poses a potential health, safety and personal right risk to the children in care.
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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:Christina Gabelman
LICENSING EVALUATOR NAME:Anomeh Eivazian
LICENSING EVALUATOR SIGNATURE:
DATE: 01/29/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/29/2024


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Document Has Been Signed on 01/29/2024 02:53 PM - It Cannot Be Edited


Created By: Anomeh Eivazian On 01/29/2024 at 02:21 PM
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: DILOVYAN FAMILY CHILD CARE
FACILITY NUMBER: 198021034

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/29/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/09/2024
Section Cited
CCR
102425(j)(2)(D)

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Infant Safe Sleep
Documentation shall be maintained in the infant’s file and be available to the Department for review. Documentation shall include the following: a. Date.
b. Infant’s name. c.Time of each 15-minute check.
This requirement was not met as evidenced by...
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Per licensee, effective 01/30/24 he will ensure to complete nap chart for each napping infant and have it available in the facility for review.
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Per licensee, he does not have infants nap chart available for review during this inspection. Per licensee staff check on napping infants all the times or one adult is present in nap room with children.
This poses a potential health, safety and personal right risk to the children in care.
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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:Christina Gabelman
LICENSING EVALUATOR NAME:Anomeh Eivazian
LICENSING EVALUATOR SIGNATURE:
DATE: 01/29/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/29/2024


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