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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198021038
Report Date: 01/30/2023
Date Signed: 01/30/2023 04:46:46 PM

Document Has Been Signed on 01/30/2023 04:46 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:MY ACADEMY PRESCHOOLFACILITY NUMBER:
198021038
ADMINISTRATOR:LIANNA NAVASARDYANFACILITY TYPE:
840
ADDRESS:302 W FOOTHILL BLVDTELEPHONE:
(818) 331-4816
CITY:MONROVIASTATE: CAZIP CODE:
91016
CAPACITY: 24TOTAL ENROLLED CHILDREN: 24CENSUS: 0DATE:
01/30/2023
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
03:01 PM
MET WITH:Lianna Navasardyan & Arpine PatatanyanTIME COMPLETED:
05:00 PM
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An announced pre-licensing site inspection was conducted today by Licensing Program Analyst (LPAs) Cynthia Reyes and Mary Silva, to inspect and measure the facility for capacity determination. Due to COVID- 19 precautionary measures were taken during this inspection. Applicant is requesting a School Age program with a capacity of 24 children. LPAs met with applicant Lianna Navasardyan and assistant Director Arpine Patatanyan, who guided analysts on a tour of the facility indoors and out.

The facility is also requesting a preschool with a toddler option (198021037). During the facility walk though the applicants decided to withdraw the school age application due to the capacity of the other programs and due to the school age program not having their own bathroom or own outdoor play yard at this time.

4 PM Exit interview conducted with applicant Lianna Navasardyan and assistant Director Arpine Patatanyan and a signed copy of this report was given on this date.
SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Cynthia Reyes
LICENSING EVALUATOR SIGNATURE: DATE: 01/30/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/30/2023
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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