103808639-7-7-2023-04-CC-DJIZ-CTHTWF-20230707150529

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 103808639
Report Date: 07/07/2023
Date Signed: 07/07/2023 03:05:52 PM

Document Has Been Signed on 07/07/2023 03:05 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
FRESNO-CC, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME:	CHARLIE KEYAN ARMENIAN COMMUNITY SCHOOL		FACILITY NUMBER:	103808639
ADMINISTRATOR:	HOVAGIMIAN, TALAR		FACILITY TYPE:	850
ADDRESS:	108 N. VILLA		TELEPHONE:	(559) 323-1925
CITY:	CLOVIS	STATE: CA	ZIP CODE:	93612
CAPACITY:	115	CENSUS: 5	DATE:	07/07/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	12:00 PM
MET WITH:	Kristine Ghazaryan		TIME COMPLETED:	03:20 PM

NARRATIVE

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On 07/07/23, Licensing Program Analyst Denisia Jimenez and Licensing Program Manager (LPM) Juvenal Moctezuma conducted an unannounced Annual random inspection. LPA & LPM were greeted by a security guard at the front gate of the school indicating that the school principal was not here today, but the preschool program was operating. LPA & LPM were allowed inside and requested to speak to the preschool staff. LPA & LPM walked over to the preschool classroom where it was observed that there were 2 staff caring for 5 children who were getting ready for nap. LPM asked if the site supervisor was available, but the staff indicated that they were not here today.

LPM spoke to the school principal over the phone who indicated that they were new to the position and were not aware of licensing requirements. LPM provided their contact information to set up a meeting to discuss about their preschool program.

During the tour and file review it was observed that the two staff caring for the 5 preschool children were not fingerprint cleared nor associated to the preschool facility. LPM asked if they could contact anyone from the fingerprint roster to come and assist with the daycare children. Staff #1 attempted to call but was unsuccessful. During today’s inspection the center is being cited a type A deficiency for having two daycare staff caring for 5 preschool children without a fingerprint clearance. Through file review it was also confirmed that none of them had a valid or up to date CPR certificate. A type B deficiency is also being cited. LPM provided both staff with a livescan form and informed them to get fingerprint as soon as possible and will need to be cleared before they can start caring for children. Staff understood.

During the file review and inspection, LPM spoke to a school board member who indicated that they would ensure that someone in the fingerprint roster will be here caring for children to avoid any further deficiencies. Parents picked up their children during the inspection and school principal & Board member indicated that they would submit the staff’s paperwork as soon as possible along with the decrease of capacity paperwork.

SUPERVISOR'S NAME: Juvenal Moctezuma	TELEPHONE: (559) 650-7869
LICENSING EVALUATOR NAME: Denisia Jimenez	TELEPHONE: (559) 767-0718
LICENSING EVALUATOR SIGNATURE:	DATE: 07/07/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/07/2023

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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
FRESNO-CC, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: CHARLIE KEYAN ARMENIAN COMMUNITY SCHOOL	FACILITY NUMBER: 103808639
	VISIT DATE: 07/07/2023

NARRATIVE

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LPM indicated that the annual inspection will continue at a further date.

Per California Code of Regulations, Title 22, Division 12, Chapter 1, the following deficiencies Type A and Type B are being cited (see 9099-D) A civil penalty of $200 is being assessed due to two staff members working at the facility without a fingerprint clearance. See LIC 421BG. Upon receipt, licensee shall post and provide copies of this licensing report to parents/guardians of children in care at the facility and to parents/guardians of children newly enrolled at the facility during the next 12 months. Appeal rights were provided.

Exit interview and appeal rights conducted with Haykuhi Hakobyan. This report is to be made available to the public upon request.

LIC 9213 Notice of Site Visit to be posted for 30 days.

SUPERVISOR'S NAME: Juvenal Moctezuma	TELEPHONE: (559) 650-7869
LICENSING EVALUATOR NAME: Denisia Jimenez	TELEPHONE: (559) 767-0718
LICENSING EVALUATOR SIGNATURE:	DATE: 07/07/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/07/2023

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 07/07/2023 03:05 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
FRESNO-CC, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: CHARLIE KEYAN ARMENIAN COMMUNITY SCHOOL	FACILITY NUMBER: 103808639
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 07/07/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type A

Section Cited

CCR

101170(e)(1)

All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1596.871 shall prior to working, residing or volunteering in a licensed facility: (1) Obtain a California clearance or a criminal record exemption as required by the Department... This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	During file review and interviewing staff it was confirmed that both staff present today did not have a fingerprint clearance nor were assocaited to the preschool license which poses an immediate health, safety or personal rights risk to persons in care.
	POC Due Date: 07/10/2023
	Plan of Correction
1 2 3 4	LPM spoke to board member and school principal whom indicated that they would have staff that are fingerprint cleared be present at the facility caring for children. Staff present today were provided with the livescan forms and indicated that they would get their fingerprints done today. Licensee to submit a written plan of correction indicating how this will not happen again and submit it to licensing before 7/10/2023.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME: Juvenal Moctezuma	TELEPHONE: (559) 650-7869
LICENSING EVALUATOR NAME: Denisia Jimenez	TELEPHONE: (559) 767-0718
LICENSING EVALUATOR SIGNATURE:	DATE: 07/07/2023

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/07/2023

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 07/07/2023 03:05 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
FRESNO-CC, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: CHARLIE KEYAN ARMENIAN COMMUNITY SCHOOL	FACILITY NUMBER: 103808639
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 07/07/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1596.866(b)

Day care center directors and licensees of family day care homes shall ensure that at least one staff member who has a current course completion card in pediatric first aid and pediatric CPR issued by the American Red Cross, the American Heart Association, or by a training program that has been approved by the Emergency Medical Services Authority pursuant to this section and Section 1797.191 shall be onsite at all times when children are present at the facility... This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on interviews & records review It was confirmed that both staff present during todays inspection did not comply with the section cited above since they do not have a CPR First Aid Certificate which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 07/31/2023
	Plan of Correction
1 2 3 4	Staff indicated that they will sign up to get trained in person and will submit training details to LPA before 07/31/2023.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME: Juvenal Moctezuma	TELEPHONE: (559) 650-7869
LICENSING EVALUATOR NAME: Denisia Jimenez	TELEPHONE: (559) 767-0718
LICENSING EVALUATOR SIGNATURE:	DATE: 07/07/2023

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/07/2023

LIC809 (FAS) - (06/04)

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