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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198021256
Report Date: 02/23/2024
Date Signed: 02/23/2024 03:37:36 PM

Document Has Been Signed on 02/23/2024 03:37 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:AZIZYAN AND HAKOBYAN FCCFACILITY NUMBER:
198021256
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 12CENSUS: 8DATE:
02/23/2024
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
01:20 PM
MET WITH:Marine Azizyan, LicenseeTIME COMPLETED:
03:45 PM
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CASE MANAGEMENT YEAR INSPECTION CONDUCTED IN ARMENIAN
Licensing Program Analyst (LPA) Anomeh Eivazian conducted an unannounced case management- licensee initiated inspection to the above facility on 02/23/24 due to licensee is requesting capacity increase. LPA arrived at the facility at 1:10 PM and met with Marine Azizyan, Licensee who guided analyst on a tour of the facility. A COVID 19 risk assessment was conducted prior to entering the facility. Also present during this inspection, was Narek Hakobyan, Licensee’s Husband/co-licensee. Based on Application LIC 279 that was received in Regional Office on 01/24/24, Licensee requested to take out co-licensee, Narek Hakobyan from licensee. Per licensee, Marine Azizyan facility hours are Monday to Saturday from 7:00 a.m. to 10:00 p.m..

Licensee previously was licensed at 510 South Belmont Street, Unit C, Glendale, CA 91205 with facility number 198021156.
Fire Clearance for Large Family Child Care Home was granted on 02/07/24.

This is a one-story home located on the first level. The home consists of 3 bedrooms, 1 & 1/2 restrooms, living room, dining room, kitchen, balcony, laundry room, front yard, backyard (fenced), detached back house which consists of a bathroom, living room, kitchen, and a bedroom. Per licensee, parents enter the home through the main entrance door which leads to the living room.

There is a in ground pool on the premises which is in the backyard. Pool is inaccessible and surrounded with cement walls in two sides, and five feet high fences, with less than 4 inches opening in two sides. Also, gates swing away from the pool, self-closed and have a self-latching device located no more than six inches from the top of the gate. The fence meets Title 22 Regulations. Per licensee pool area is off-limit and inaccessible to the children.
REPORT CONTINUES ON NEXT PAGE 1 of 5
SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Anomeh Eivazian
LICENSING EVALUATOR SIGNATURE: DATE: 02/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/23/2024
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: AZIZYAN AND HAKOBYAN FCC
FACILITY NUMBER: 198021256
VISIT DATE: 02/23/2024
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Per licensee at 1:30 PM, the children use the bathroom in the hallway, half bathroom, living room, dining room, kitchen, two bedrooms, laundry room, balcony adjacent to the dining room, and side yard (fenced).

Per licensee areas off limits to children and parents include: One-bedroom, back balcony adjacent to the laundry room, pool area in the backyard, front yard, and entire detached guests house which consists of a bedroom, one bathroom, living room, kitchen. LPA did not observe any stairs in the home during this inspection. 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 1:30 pm., Licensee took this LPA on a tour of 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. There is a fireplace in the living room which is covered with bookshelf. LPA observed a sofa, children tables, and chairs in the living room. LPA observed a chain lock on the main entrance door, located six feet high. LPA observed five children were playing in the living room. During this inspection three children were dropped off from school and total of 8 children were present in the home. Next to the living room, the dining room was inspected, and LPA observed a foldable table, chairs, a sofa, a children table and chairs in the dining room. Next LPA toured the balcony adjacent to the dining room and observed a foldable table and four chairs in the balcony. Next LPA toured the one off-limit bedroom and did not observe any hazards. Next LPA toured the two daycare bedrooms and did not observe any hazards. LPA observed children’s toys and napping cots in the bedroom in the hallway. LPA observed foldable tables and chairs in the bedroom adjacent to the kitchen. Next LPA toured the one bathroom in the hallway and observed child proof safety latches on the cabinets under the sink and on the shower door. Next LPA toured the half bathroom inside the bedroom and did not observe any hazards. Next LPA toured the kitchen and observed child proof safety latches on the cabinets where licensee store sharp items and cleaning compounds. Next LPA toured the laundry room and did not observe any hazards. Per licensee, children walk through the kitchen and laundry room to go to the side yard. LPA observed the required 2A 10BC fire extinguisher was placed on the cabinet in the kitchen. It was purchased on 01/29/24 as read by LPA from the receipt. Licensee tested the carbon monoxide and smoke detectors in the bedroom 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.
REPORT CONTINUES ON NEXT PAGE 2 of 5
SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Anomeh Eivazian
LICENSING EVALUATOR SIGNATURE:

DATE: 02/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/23/2024
LIC809 (FAS) - (06/04)
Page: 2 of 5
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: AZIZYAN AND HAKOBYAN FCC
FACILITY NUMBER: 198021256
VISIT DATE: 02/23/2024
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Next LPA toured the backyard fenced. Per licensee, pool area in the backyard and detached guests house are off-limit. Per licensee, pool gate is be kept closed all the times during outdoor playtime. Per licensee, back balcony which is adjacent to the laundry room is off-limit and children only transpass to go to the side yard. Per licensee, children use the side yard (fenced) for outdoor activity. The outdoor play area was observed to be fenced. 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 licensee states that supervision is always provided. LPA observed child safety gate in the back balcony to make the back balcony inaccessible to the children.

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, at 2:15 p.m. there are no pets, weapons, or firearms on the premises.

The licensee was observed to be operating within the licensed capacity and is not exceeding the required limitations during this inspection. During this inspection eight children were present in the home, four being school age with licensee and her husband. 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.

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 10/24. Licensee, Marine Azizyan completed required mandated reporter training on 11/03/22. There are first aid supplies available on the premises in the kitchen in a cabinet. LPA advised licensee that if a child shows signs of illness he/she/they shall be separated from other children. At 2:30 PM, the facility roster was reviewed and completed. Per licensee currently there are 12 children enrolled. LPA reviewed 5 children's records, including emergency information from 12 enrolled children, and all 5 reviewed files were completed.
REPORT CONTINUES ON NEXT PAGE 3 of 5
SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Anomeh Eivazian
LICENSING EVALUATOR SIGNATURE:

DATE: 02/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/23/2024
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: AZIZYAN AND HAKOBYAN FCC
FACILITY NUMBER: 198021256
VISIT DATE: 02/23/2024
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The licensee and her husband 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 01/25/24.

Emergency Disaster Plan, Parent’s Rights Poster and the Facility License were observed to be posted at the wall in the dining 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 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 5 reviewed files.

INFANT CARE: Licensee states that currently she does not have any infant enrolled in her daycare. Licensee states that if an infant is enrolled, the infant will sleep in the two bedrooms 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 4 of 5
SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Anomeh Eivazian
LICENSING EVALUATOR SIGNATURE:

DATE: 02/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/23/2024
LIC809 (FAS) - (06/04)
Page: 4 of 5
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: AZIZYAN AND HAKOBYAN FCC
FACILITY NUMBER: 198021256
VISIT DATE: 02/23/2024
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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, Marine Azizyan at 3:45 p.m..
REPORT END 5 of 5
SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Anomeh Eivazian
LICENSING EVALUATOR SIGNATURE:

DATE: 02/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/23/2024
LIC809 (FAS) - (06/04)
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