198021134-1-17-2024-33-CC-AEIN-CZKRJ6-20240117120324

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198021134
Report Date: 01/17/2024
Date Signed: 01/17/2024 12:03:31 PM

Document Has Been Signed on 01/17/2024 12:03 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:	AVAGYAN FAMILY CHILD CARE		FACILITY NUMBER:	198021134
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 8	CENSUS: 4	DATE:	01/17/2024
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME BEGAN:	10:35 AM
MET WITH:	Meri Avagyan, Licensee		TIME COMPLETED:	12:15 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	CASE MANAGEMENT INSPECTION CONDUCTED IN ARMENIAN Licensing Program Analyst (LPA) Anomeh Eivazian conducted an unannounced case- management inspection to the above facility on 01/17/24 due to licensee is requesting capacity increase. LPA arrived at the facility at 10:35 AM and met with Meri Avagyan, Licensee who guided analyst on a tour of the facility. Also present during this inspection, was Armine Karaptyan, Licensee’s Assistant. Per licensee, facility hours are Monday to Saturday from 7:00 a.m. to 11:00 p.m. Fire clearance for Large Family Child Care was granted on 12/13/23. 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, covered patio, backyard (fenced) and front yard. Per licensee, parents mainly enter the home through the main entrance door which leads to the living room and side gate which leads to the backyard (fenced). Per licensee the children use the Bathroom in the hallway, living room, dining room, one bedroom, and backyard (fenced). Per licensee areas off limits to children and parents include: Two bedrooms, bathroom in the master bedroom, kitchen, front yard, and back of backyard. LPA did not observe any stairs in the home. During this inspection individuals who reside in the home were discussed and notes on Confidential Name List (LIC811) and attached to this report. There is a detached three car garage and detached dwelling over three car garage with separated address, 537 W. Doran Street unit A in the back of the house. Licensee's mother, Parandzem Khachatryan is also Family Child Care Home provider in the back unit at 537 W. Doran Street #A, Glendale, CA 91203 with facility number 198021300. All areas identified on the facility sketch that are accessible for children to use were inspected for safety, comfort, and cleanliness. At 10:50 a.m, the licensee began touring LPA’s through the home starting with the entry way which lead directly to the living room. The living room was inspected and electrical outlets were observed to be covered. LPA observed sofas and a coffee table in the living room. Next LPA toured the dining REPORT CONTINUES ON NEXT PAGE 1 of 4

SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Anomeh Eivazian
LICENSING EVALUATOR SIGNATURE:	DATE: 01/17/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/17/2024

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: AVAGYAN FAMILY CHILD CARE	FACILITY NUMBER: 198021134
	VISIT DATE: 01/17/2024

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room and observed children toys, children tables and chairs in the dining room. LPA observed four children were playing in the living room with licensee and her assistant. Next LPA toured the kitchen and did not observe any hazards. LPA observed two child safety gates were installed to the kitchen to make the kitchen inaccessible to the children. Next LPA toured the daycare bedroom adjacent to the living room and observed children toys and napping cots in the daycare bedroom. Next LPA toured the bathroom in the hallway and did not observe any hazards. Next LPA toured the off-limit master bedroom, off-limit bathroom in the master bedroom and off-limit bedroom and did not observe any hazards. LPA observed licensee's family members personal belongings in the home. Per licensee, no poisons are kept in the home. LPA observed the required 2A 10BC fire extinguisher was anchored to the wall in the living room. It was serviced on 12/12/23 as read by LPA from the service tag. Licensee tested the carbon monoxide and smoke detectors in the living room. Both 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 LPA toured the backyard fenced. Per licensee, children use the back yard for outdoor play time. The outdoor play area was observed to be fenced and separated by gates from off-limit areas in the backyard. LPA 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 outdoor playarea ground is artificial grass. The licensee states that supervision is always provided. Next LPA toured the covered patio and did not observe any hazards.

Per licensee, she 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, Meri Avagyan at 11:15 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 has one assistant. 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 4

SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Anomeh Eivazian
LICENSING EVALUATOR SIGNATURE:	DATE: 01/17/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/17/2024

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: AVAGYAN FAMILY CHILD CARE	FACILITY NUMBER: 198021134
	VISIT DATE: 01/17/2024

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 11/24. Licensee, Meri Avagyan completed required mandated reporter training on 11/01/24. There are first aid supplies available on the premises in the kitchen. LPA advised licensee that if a child shows signs of illness he/she/they shall be separated from other children.

At 11:30 a.m., facility roster was reviewed and completed. Per licensee currently there are eight children enrolled. LPA reviewed four children's records, including emergency information from eight enrolled children, and all four reviewed files were completed.

The licensee and her assistant 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. Last drill documented was conducted on 12/16/23.

Emergency Disaster Plan, Parent’s Rights Poster and the Facility License were observed to be posted at the wall by the entrance. 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, her husband smokes but not in the home. There is telephone service via a cellphone 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 four reviewed files.

INFANT CARE: Licensee states that she provides care to infants but currently she does not have any infants enrolled in her daycare. Per licensee, if an infant is enrolled, the infant will sleep in the living room or daycare bedroom where they are constantly supervised. 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: 01/17/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/17/2024

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: AVAGYAN FAMILY CHILD CARE	FACILITY NUMBER: 198021134
	VISIT DATE: 01/17/2024

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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

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.

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.

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, Meri Avagyan at 12:15 p.m..

REPORT END 4 of 4

SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Anomeh Eivazian
LICENSING EVALUATOR SIGNATURE:	DATE: 01/17/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/17/2024

LIC809 (FAS) - (06/04)

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