<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198021226
Report Date: 09/05/2025
Date Signed: 09/05/2025 10:46:12 AM

Document Has Been Signed on 09/05/2025 10:46 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:ANTONYAN FAMILY CHILD CAREFACILITY NUMBER:
198021226
ADMINISTRATOR/
DIRECTOR:		ANTONYAN, NUNEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(818) 370-9565
CITY:GLENDALESTATE: CAZIP CODE:
91201
CAPACITY: 14TOTAL ENROLLED CHILDREN: 12CENSUS: 7DATE:
09/05/2025
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:23 AM
MET WITH:Nune Antonyan, LicenseeTIME VISIT/
INSPECTION COMPLETED:
11:00 AM
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 WAS COMPLETED IN ARMENIAN

Licensing Program Analyst (LPA) Anomeh Eivazian conducted an unannounced case management inspection to the above facility on 09/05/25 due to licensee’s daughter, Iren Stepanyan applied for family child care home license for the unit A in the back of this house. LPA arrived at the facility at 9:23 AM and met with licensee, Nune Antonyan who guided analyst on a tour of the facility. During this inspection the licensee’s mother, Melsida Antonyan and Manan Grigoryan, licensee’s assistant were also present in the home. During this inspection 7 children were present in the home, playing in the living room.

This is a one-story home located on the first level. The home consists of 3 bedrooms, 2 restrooms, living room, dining room, family room, kitchen, laundry room, front yard, and backyard (fenced). There are two ADUs in the back of the home with separated addresses, Unit A and Unit AA.

Per licensee, parents enter the home through the main entrance door which leads to the living room.

Licensee’s daughter Iren Stepanyan applied for family child care home license for 1354 Alameda Ave, unit A, Glendale, CA 91201 with facility number 198021774.

LPA Eivazian reviewed and discussed with the licensee the following Title 22 Regulations to ensure licensee maintain compliance and meet the Title 22 regulations at all times.

The 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.


REPORT CONTINUES ON NEXT PAGE 1 of 3
NAME OF LICENSING PROGRAM MANAGER: Christina Gabelman
NAME OF LICENSING PROGRAM ANALYST: Anomeh Eivazian
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 09/05/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/05/2025
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
California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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: ANTONYAN FAMILY CHILD CARE
FACILITY NUMBER: 198021226
VISIT DATE: 09/05/2025
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
26
27
28
29
30
31
32
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.

Definitions--102352 (a) (3)--"Assistant Provider" means a person at least 14 years of age who is primarily involved in caring for children during the hours that the home provides care.

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.

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.

Staffing Ratio and Capacity--102416.5 (a)--The capacity specified on the license shall be the maximum number of children for whom care may be provided at any one time.

Per licensee, Nune Antonyan facility Rosters and children's files for enrollment will be updated all the time.

Licensee and her daughter, Iren Stepanyan with facility number 198021774 have separate outdoor playarea.

Licensee’s kitchen door and backyard gate leads to Stepanyan Family Child Care, unit A outdoor playarea. Per licensee, she will keep the kitchen door locked all the time. Also, backyard gate which leads to unit A, will be kept locked all the time during daycare operation hours.

- Licensee will be the main person to provide care to the children and interact with families.

- Licensee will interact with Department staff professionally and respectfully at all times. Licensee understands that inspections are conducted in person, unannounced, and Department staff will be granted access to the facility as part of the inspection process.


REPORT CONTINUES ON NEXT PAGE 2 of 3
NAME OF LICENSING PROGRAM MANAGER: Christina Gabelman
NAME OF LICENSING PROGRAM ANALYST: Anomeh Eivazian
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 09/05/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/05/2025
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: ANTONYAN FAMILY CHILD CARE
FACILITY NUMBER: 198021226
VISIT DATE: 09/05/2025
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
26
27
28
29
30
31
32
- Licensee will be forthright with the department all the times to ensure the health and safety of children in care.

- Licensee will keep her daycare children records at this address all the time.

During this inspection licensee submitted a written declaration that her daycare children will not commingle with Stepanyan Family Child Care Home, 198021774 children at any time and licensee will keep the kitchen door and backyard gate locked all the time.

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, Nune Antonyan.


REPORT END 3 of 3
NAME OF LICENSING PROGRAM MANAGER: Christina Gabelman
NAME OF LICENSING PROGRAM ANALYST: Anomeh Eivazian
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 09/05/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/05/2025
LIC809 (FAS) - (06/04)
Page: 4 of 4