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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191203519
Report Date: 06/18/2020
Date Signed: 06/18/2020 02:40:10 PM

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:ST MARY'S ARMENIAN SCHOOLFACILITY NUMBER:
191203519
ADMINISTRATOR:AGHAZARIAN, ARSINEFACILITY TYPE:
850
ADDRESS:1200 E CARLTON DRIVETELEPHONE:
(818) 240-7030
CITY:GLENDALESTATE: CAZIP CODE:
91205
CAPACITY:200CENSUS: 0DATE:
06/18/2020
TYPE OF VISIT:Case Management - OtherANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Arsine Aghazarian, DirectorTIME COMPLETED:
12:30 PM
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CASE MANAGEMENT INSPECTION CONDUCTED IN ARMENIAN
This was a case management inspection conducted by Licensing Program Analyst (LPA) Anomeh Eivazian due to COVID-19 and precautionary measures. This case management inspection was conducted with Arsine Aghazarian, director as technician assistant to reopen the preschool.

Currently school is closed due to Covid-19. At 10:00 am, LPA Eivazian did not observe any children present in the facility. At 10:00 am, director took this LPA on a tour of all classrooms and discussed facility plans and changes prior to reopen the facility.

LPA Eivazian reviewed and discussed PIN 20-06, and Covid-19 Self Assessment during this inspection.

No deficiencies were observed or cited in accordance with Title 22 California Code of Regulations on this date.

The Notice of Site Visit (LIC 9213) – must remain posted for 30 days during the hours of operation after each site visit by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00.

Exit interview was conducted with Arsine Aghazarian, Director including, but not limited to Provider Rights, Appeal Procedures and Agencies Consultative Role.
SUPERVISOR'S NAME: Christina GabelmanTELEPHONE: (323) 854-8930
LICENSING EVALUATOR NAME: Anomeh EivazianTELEPHONE: (323) 981-3391
LICENSING EVALUATOR SIGNATURE:

DATE: 06/18/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/18/2020
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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