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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198021275
Report Date: 08/18/2023
Date Signed: 08/18/2023 10:26:43 AM

Document Has Been Signed on 08/18/2023 10:26 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:DEMIRCHYAN FAMILY CHILD CAREFACILITY NUMBER:
198021275
ADMINISTRATOR:DEMIRCHYAN, SUZANAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(323) 369-6103
CITY:GLENDALESTATE: CAZIP CODE:
91204
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 0DATE:
08/18/2023
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
08:40 AM
MET WITH:Suzanna Demirchyan, ApplicantTIME COMPLETED:
10:30 AM
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PRELICENSING INSPECTION CONDUCTED IN ARMENIAN

Licensing Program Analyst (LPA) Anomeh Eivazian conducted an announced pre-licensing follow up inspection to the above facility on 08/18/2023. LPA arrived at the facility at 8:40 AM and met with Suzanna Demirchyan, Applicant who guided analyst on a tour of the facility.

The following was observed during this inspection:
1. LPA observed the fireplace in the living room was screened to prevent access.
2. There is a working telephone service via landline available in the home .
3. LPA observed Applicant added a gate in the patio to make the stairs which leads to the backyard inaccessible to the children.
4. LPA observed child proof safety latches in the kitchen on cabinets where applicant stores cleaning compounds and sharp items.
5. LPA observed AC unit in the backyard was screened and inaccessible to the children.
6. Applicant submitted a written declaration regarding her use of detached garage for limited activity only.
7. Applicant will submitted a written plan that she will be present in the Family Child Care Home 80% of the time.

A large 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, Suzanna Demirchyan at 10:30 AM.
SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Anomeh Eivazian
LICENSING EVALUATOR SIGNATURE: DATE: 08/18/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/18/2023
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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