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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198021560
Report Date: 12/01/2025
Date Signed: 12/01/2025 10:05:13 AM

Document Has Been Signed on 12/01/2025 10:05 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:SAROYAN FAMILY CHILD CAREFACILITY NUMBER:
198021560
ADMINISTRATOR/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 6CENSUS: 0DATE:
12/01/2025
TYPE OF VISIT:OfficeANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:00 AM
MET WITH:Hasmik Saroyan, LicenseeTIME VISIT/
INSPECTION COMPLETED:
10:00 AM
NARRATIVE
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An informal office meeting was conducted on 12/01/2025 at 9:00 AM at the Monterey Park Regional Office. Present during the meeting were Hasmik Saroyan, licensee, Licensing Program Manager (LPM) Christina Gabelman and Licensing Program Analyst (LPA) Anomeh Eivazian. The purpose of this Informal Meeting is to discuss the history of the facility prior to approving capacity increase application and the licensee’s responsibility to ensure that the health and safety of children in care are protected at all times.

The summary of history includes 8 Type B deficiencies that were cited on 09/24/25:

Type B Deficiencies include:

- The 2A10BC fire extinguisher was purchased on 09/06/24 and it was not serviced annually as it is required.


- LPA observed child safety latches in the kitchen drawer where licensee stores knives and under the sink cabinet where licensee stores cleaning compounds did not work properly.
- Licensee checked on napping infants every 15 minutes but did not complete the napping log.
- Licensee did not have current facility roster.
- 3 out of 6 Children did not have required immunization on file.
- Licensee did not complete daily inspection from the pool.
- Licensee did not conduct fire drill every six months as it is required.
- Licensee did not have an alarm in a swimming pool as it is required based on AB 2866.

Deficiencies mentioned above have been corrected.


REPORT CONTINUES ON NEXT PAGE 1 of 4
NAME OF LICENSING PROGRAM MANAGER: Christina Gabelman
NAME OF LICENSING PROGRAM ANALYST: Anomeh Eivazian
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 11/24/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/24/2025
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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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)
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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: SAROYAN FAMILY CHILD CARE
FACILITY NUMBER: 198021560
VISIT DATE: 12/01/2025
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On 10/27/25, LPA Eivazian conducted a plan of correction inspection to the facility. Upon LPA Eivazian arrival to the facility LPA heard children noise from the backyard. LPA went to the side gate, through the fence, LPA observed a male adult watching the kids on the swing, three children were on the swing, LPA observed two children, female in black and white (dress or shirt) by the swing. LPA said hi to the male individual, this is Anomeh, Male individual, licensee's husband turned back and LPA heard licensee's voice, husband said it is Anomeh, they did not come to open the door or side gate right away, at that time, husband went to an area in the back yard, where LPA was not able to see them. The two girls in the black and white shirt/dress went toward the backyard and LPA did not see them again.

In a couple minutes, licensee came to the side gate and opened the side gate said she went inside to get the side gate remote, LPA entered the facility through the side gate, counted 6 children, two infants, LPA did not see the two girls that she observed at first through the gate and husband was not present anymore. LPA right away went through the house to the front yard but did not see licensee’s husband and the two girls. LPA asked licensee to check the camera footage, licensee stated currently the cameras are not working.

Per licensee, her husband left the home in rush to work and she only had 6 children in care.

On 10/27/25, LPA informed licensee, that she observed two girls in daycare whom she did not see in the daycare upon her arrival inside the facility in the backyard or inside the home. LPA informed licensee, that with counting those two girls with six present children in the daycare, total of 8 children were present in the facility while LPA was waiting outside, and licensee was out of her license limitation with 2 children.

LPM Gabelman reviewed following Title 22 Regulations:

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.


REPORT CONTINUES ON NEXT PAGE 2 of 4
NAME OF LICENSING PROGRAM MANAGER: Christina Gabelman
NAME OF LICENSING PROGRAM ANALYST: Anomeh Eivazian
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 12/01/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/01/2025
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: SAROYAN FAMILY CHILD CARE
FACILITY NUMBER: 198021560
VISIT DATE: 12/01/2025
NARRATIVE
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LPM Gabelman informed the licensee that during her absence from the facility during facility operation hours she is required to have qualified assistants present in the home and meet the Staffing and Ratio requirements at all the times. Also, LPM Gabelman advised licensee to train her staff to open the facility door for licensing staff during her absence.

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.

Licensee will be forthright with the department all the times to ensure the health and safety of children in care.

The Licensee will also be required to view the following videos on the Department website https://ccld.childcarevideos.org/:


- Record Keeping in Family Child Care
- What is Civil Penalty
- Community Care Licensing Inspection Authority
- How many children can attend a Family Child Care Home
- Children's Personal Rights in the Child Care
- Supervising Children in Family Child Care Home

Licensee was informed that the department will grant a large family child care license; however, the department will conduct more frequent inspections for a year to ensure that the licensee is in compliance with Title 22 Regulations.

Please visit the Child Care Licensing website at: www.ccld.ca.gov for quarterly updates, forms, and regulations.


REPORT CONTINUES ON NEXT PAGE 3 of 4
NAME OF LICENSING PROGRAM MANAGER: Christina Gabelman
NAME OF LICENSING PROGRAM ANALYST: Anomeh Eivazian
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 12/01/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/01/2025
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: SAROYAN FAMILY CHILD CARE
FACILITY NUMBER: 198021560
VISIT DATE: 12/01/2025
NARRATIVE
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The following deficiencies listed on the attached LIC 809 (deficiency page) are being cited in accordance with California Code of Regulations Title 22. Deficiencies that are being cited need to be cleared to protect the children’s health & safety.

LPM Gabelman informed licensee, Hasmik Saroyan that this report dated 12/01/25 document(s) 2 Type A citation. Type A citation(s) which shall be posted for 30 consecutive days as there is/are immediate risk(s) to the health, safety, or personal rights of children in care.

Also, LPM Gabelman informed the licensee, Hasmik Saroyan to provide a copy of this licensing report dated 12/01/25 that documents any Type A citation(s) to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in each child's file for verification.

The licensee is required to provide copies of this Informal meeting to parents. The licensee will provide a copy of this report to the parent/guardian of children currently enrolled by the next business day or immediately upon return. A copy of this report shall also be provided to the parent/guardian of any newly enrolled children for the next 12 months (1 year). The licensee will obtain a signature and date from the child's parent/guardian on the Acknowledgement of Receipt of Licensing Reports (LIC 9224). The licensee will keep a record immediately upon receipt of the completed and signed LIC 9224 acknowledging receipt of this report in the child's file. Licensee was provided a copy of the LIC9224.

An exit interview conducted, and a copy of this report was provided to licensee, Hasmik Saroyan.

REPORT END 4 of 4

NAME OF LICENSING PROGRAM MANAGER: Christina Gabelman
NAME OF LICENSING PROGRAM ANALYST: Anomeh Eivazian
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 12/01/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/01/2025
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 12/01/2025 10:05 AM - It Cannot Be Edited


Created By: Anomeh Eivazian On 12/01/2025 at 08:35 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: SAROYAN FAMILY CHILD CARE
FACILITY NUMBER: 198021560

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/01/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
12/02/2025
Section Cited
CCR
102402(a)(3)

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Revocation or Suspension of a License or Registration:Conduct in the operation or maintenance of a family day care home which is inimical to the health, morals, welfare, or safety of either an individual in or receiving services from the facility or the people of the State of California. This requirement was not met as evidenced by:
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Per licensee, she will be truthful moving forward and will follow Title 22 Regulation all the time.
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Based on LPA Eivazian observation on 10/27/25, LPA observed two girls from the side gate in the backyard that did not see them in the facility upon her arrival inside the facility and licensee stated only she had 6 children present. This poses an immediate health, safety and personal right risk to the children in care.
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Type A
12/02/2025
Section Cited
CCR102416.5(a)

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Staffing Ratio and Capacity
(a) The capacity specified on the license shall be the maximum number of children for whom care may be provided at any one time.
This requirement was not met as evidenced by:
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Per licensee, she will be truthful moving forward and will follow Title 22 Regulation all the time.
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Based on LPA Eivazian observation on 10/27/25, LPA observed two girls from the side gate in the backyard that did not see them in the facility upon her arrival inside the facility and licensee stated only she had 6 children present. This poses an immediate health, safety and personal right risk to the children in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Christina Gabelman
NAME OF LICENSING PROGRAM MANAGER:
Anomeh Eivazian
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 12/01/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/01/2025


LIC809 (FAS) - (06/04)
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