198021161-1-27-2023-33-CC-AEIN-CNGULG-20230127144043

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198021161
Report Date: 01/27/2023
Date Signed: 01/27/2023 02:40:50 PM

Document Has Been Signed on 01/27/2023 02:40 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:	ATOIAN FAMILY CHILD CARE		FACILITY NUMBER:	198021161
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 0	CENSUS: 0	DATE:	01/27/2023
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	11:40 AM
MET WITH:	Temine Atoian, Applicant		TIME COMPLETED:	03:00 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	PRELICENSING INSPECTION CONDUCTED IN ARMENIAN Licensing Program Analyst (LPA) Anomeh Eivazian conducted an announced pre-licensing inspection to the above facility on 01/27/2023. LPA arrived at the facility at 11:40 AM and met with Termine Atoian, Applicant who guided analyst on a tour of the facility. Pre-licensing Entrance Checklist (LIC9280) was provided to applicant, Termine Atoian. During this inspection individuals who reside in the home were discussed and notes on Confidential Name List (LIC811) and attached to this report. A COVID 19 risk assessment was conducted prior to entering the facility. Per applicant operation hours will be Monday to Saturday, 6:00 a.m. to 11:00 p.m.. Applicant states she will care for children 0-13 years old. All areas identified on the facility sketch were inspected. This is an apartment complex located on the first level. The home consists of 2 bedrooms, 1 & 1/2 restrooms, living room, dining room, kitchen, front yard, backyard (fenced), and garage. Per applicant, parents will enter the home through the main entrance door which leads to the living room. Areas that are accessible to children are as follows: Bathroom in the hallway, living room, dining room, one bedroom adjacent to the dining room, kitchen, and backyard (fenced). Areas off limits based on facility sketch submitted to children and parents include: Master bedroom, half bathroom in the master bedroom, front yard, and garage. Rooms that are off-limits need to be made inaccessible during operating hours The applicant does understand that licensing staff may have access to off-limit areas during inspection visit if necessary. At 12:00 pm, the applicant 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 room and observed a dining table and chairs in the dining room. Next LPA touted the bedroom and observed two beds, a children REPORT CONTINUES ON NEXT PAGE 1 of 4

SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Anomeh Eivazian
LICENSING EVALUATOR SIGNATURE:	DATE: 01/27/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/27/2023

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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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: ATOIAN FAMILY CHILD CARE	FACILITY NUMBER: 198021161
	VISIT DATE: 01/27/2023

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table, chairs, and toys in the bedroom. Next LPA toured the bathroom in the hallway and did not observe any hazards. Next LPA toured the master bedroom and half bathroom in the master bedroom and did not observe any hazards. LPA observed applicant's family members personal belongings in the home. Next LPA toured the kitchen and observed child proof safety latches on the cabinets where applicant stores sharp items and cleaning compounds. Per applicant, no poisons are kept in the home. LPA observed the required 2A 10BC fire extinguisher was anchored to the wall in the dining room. It was purchased on 01/15/23 as read by LPA from the receipt. Applicant tested the carbon monoxide and smoke detectors in the hallway. 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 applicant, children will use the back yard for outdoor play time. The outdoor play area was observed to be fenced. LPA observed hammer and sharp items accessible in the backyard. LPA observed there are stairs in the backyard which leads to the second floor neighbor home. Per applicant, second floor neighbor do not have access to the backyard and do not commute from backyard. LPA observed there is a door in the backyard which leads to the garage. Per applicant, they do not have access to the garage. The applicant states that supervision is always provided.

The applicant states that they will provide food for children in care. Applicant 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 applicant, at 1:00 pm, there are no pets, weapons, firearms or bodies of water on the premises. There are toys available for children. Currently there is not a working phone in the home. LPA advised applicant that if a child shows signs of illness he/she/they shall be separated from other children. Per applicant no one smokes in the home. There are first aid kit in the home, in the kitchen.

Applicant has proof of CPR and First Aid training as indicated on the certificate. The applicant does have proof of Health and Safety training (completion date:08/20/2022), Pediatric First Aid and CPR (ex. 09/2024). The applicant has proof of immunization against influenza, pertussis, and measles.
Applicant completed required mandated reporter training on 12/29/2022. Mandated reporter training must be completed every 2 years. www.mandatedreporterca.com
REPORT CONTINUES ON NEXT PAGE 2 of 4

SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Anomeh Eivazian
LICENSING EVALUATOR SIGNATURE:	DATE: 01/27/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/27/2023

LIC809 (FAS) - (06/04)

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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: ATOIAN FAMILY CHILD CARE	FACILITY NUMBER: 198021161
	VISIT DATE: 01/27/2023

NARRATIVE

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-No smoking, No infant walkers, No Johnny jumpers, No saucer chairs, No trampolines and any other item that falls into that category are not permitted in the facility.
-All adults living and working in the home shall be made of aware of the Departments right to inspection authority, which includes but not limited to the right to enter the home when children are being cared for, interview children and adults and review documentation.
- Applicant shall reveal each facility license number in all advertisements, publications or announcements with the intent to attract clients.
- Emergency Disaster Plan, Parent’s Rights Poster and the Facility License are required to be posted.

INFANT CARE: Applicant states that she will care for infants. Applicant states that infants will sleep in the living room, dining room and one bedroom where they are constantly be supervised. Appropriate sleeping arrangements and cribs will be available once an infant being enrolled. LPA informed one crib for each infant in care will be needed. Cribs or play yard shall not hinder the entrance or exit from the sleeping space, mattresses shall be firm and covered with a fitted sheet that overlaps the underside so it cannot be dislodged. Cribs and play yards shall be free of loose articles and objects. No objects shall be hanging above or attached to the side of the crib. LPA informed Applicant infants can not be swaddled while in care. LPA advised the Applicant 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 Applicant. LPA provided the Applicant 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.

SAFE SLEEP: LPA discussed the safe sleep regulations with applicant and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed applicant of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

REPORT CONTINUES ON NEXT PAGE 3 of 4

SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Anomeh Eivazian
LICENSING EVALUATOR SIGNATURE:	DATE: 01/27/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/27/2023

LIC809 (FAS) - (06/04)

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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: ATOIAN FAMILY CHILD CARE	FACILITY NUMBER: 198021161
	VISIT DATE: 01/27/2023

NARRATIVE

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Medication: Incidental Medical Services (IMS) policy was discussed .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
Per applicant, there are no dual licenses at this address. Applicant’s email address was obtained during this inspection. The applicant was advised that email may be public information.
Per applicant, she does not carry liability insurance or a bond in accordance with standard established by Family Child Care statue. Signed statements (LIC282) will be on children’s files. The law requires Family Child Care provider to carry liability insurance or bond in the amount of $300,000 annually or to maintain the signed statement in the facility file.
To receive important licensed-related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.
LPA reviewed with applicant the LIC 311D, Forms/Records To Keep In Your Family Child Care Homes, children’s forms/records, facility forms/records, and information to be posted.
The following corrections need to be corrected prior to obtaining a small family child care license. Corrections are due by 02/27/2023
1. Applicant will submit livescan fingerprint for Hovhannes Aghabekyan. Per applicant he does not live in this address, but LPA observed personal belonging for him in the master bedroom.
2. Applicant will have a working telephone services available in the home during daycare hours.
3. Applicant will submit an updated Yard Facility sketch.
4. Applicant will arrange with landlord to open the garage for next LPA's inspection.
5. Applicant will add railing to the kitchen stairs which leads to the backyard to make it safe for children.
6. Applicant will add child safety gate to the stairs in the backyard which leads to the second floor neighbor.
7. Applicant will clean the backyard to make it safe for children.
A small family child care license will be granted upon receipt of proof of corrections for the above. 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, Temine Atoian at 3:00 p.m..
REPORT END 4 of 4

SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Anomeh Eivazian
LICENSING EVALUATOR SIGNATURE:	DATE: 01/27/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/27/2023

LIC809 (FAS) - (06/04)

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