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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198021414
Report Date: 03/04/2024
Date Signed: 03/04/2024 09:14:04 AM

Document Has Been Signed on 03/04/2024 09:14 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:HOVHANNISYAN FAMILY CHILD CAREFACILITY NUMBER:
198021414
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
03/04/2024
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
08:10 AM
MET WITH:Gayane HovhannisyanTIME COMPLETED:
09:30 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 03/04/2024. LPA arrived at the facility at 8:10 AM and met with Gayane Hovhannisyan, Applicant who guided analyst on a tour of the facility. Per applicant operation hours will be Monday to Friday, 6:00 a.m. to 11:00 p.m.. Applicant states she will care for children 3 months old -13 years old.

The following's were observed during this inspection:
1. LPA observed applicant's personal belongings in the home.
2. Applicant has a working telephone services via cellphone line that will stay in the home during day care hours. (818)799-2714.
3. Applicant has a first aid kit available in the home in the kitchen.
4. Applicant submitted proof of immunization against Pertussis for applicant.
5. Applicant added a latch to the front yard gate, out of reach of children for additional safety. Also, a door ring was installed by the main entrance door.

LPA observed a sofa, a small coffee table, a piano, two children tables, chairs in the living room. LPA observed a full size fridge in the kitchen. LPA observed a foldable sofa bed and applicant's personal belongings in the bedroom.

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, Gayane Hovhannisyan at 9:30 AM.
SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Anomeh Eivazian
LICENSING EVALUATOR SIGNATURE: DATE: 03/04/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/04/2024
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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