197403536-10-4-2019-12-CC-JSIS-BGN266-20191004170636

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197403536
Report Date: 10/04/2019
Date Signed: 10/04/2019 05:06:49 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1605 EAST PALMDALE BLV, STE A
PALMDALE, CA 93550

FACILITY NAME:	KUSHNATSIAN FAMILY DAY CARE		FACILITY NUMBER:	197403536
ADMINISTRATOR:	KUSHNATSIAN, SUSAN		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(818) 366-6815
CITY:	NORTHRIDGE	STATE: CA	ZIP CODE:	91326
CAPACITY:	14	CENSUS: 6	DATE:	10/04/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	02:25 PM
MET WITH:	Susan Kushnatsian		TIME COMPLETED:	05:21 PM

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Licensing Program Analyst (LPA) Sims and (LPA) Lawson were greeted by Licensee, Susan Kushnatsian. LPAs were at the facility to conduct an unannounced random annual inspection. LPAs disclosed the purpose of the visit and were granted entry by licensee, who guided LPAs on a tour of the facility.

Upon arrival, LPAs observed in the living room 1 infant and 5 preschool aged children in care for a total of six children. There were two adults providing care for the children, both associated to the facility and fingerprint cleared. The facility's hours of operation are Monday through Friday 7:30 a.m. to 5:30 p.m. The licensee provides breakfast, snack, lunch, and dinner. Per the licensee, there is is a dog in the home who is trained to be with children, but the pet is kept upstairs on the second floor when children are in care. Children are not transported while in care.

This is a two story, three bedroom, four bathroom home with an attached garage. Main care is provided in the family room, and living room. The children use the bathroom attached to the living room. A side portion of the backyard is used for outside play. This outside child play area has hanging material which provides shade. The off limit areas include the kitchen, and all other areas of the house except for the family room, and living room.

The home was inspected inside and out for safety, comfort, cleanliness, telephone service, heating and ventilation, inaccessibility to poisons, detergents, cleaning compounds, medicines, and hazardous items that can pose a danger to children. There are age appropriate toys and equipment on the premises. Per the licensee there are no weapons or firearms of any kind in the facility at this time, nor did the LPAs observe any weapons during the inspection. Licensee would store medication, if present, and sharp knives in the inaccessible kitchen area.

SUPERVISOR'S NAME: Claretta Yates	TELEPHONE: (661) 789-6944
LICENSING EVALUATOR NAME: Jesse Sims	TELEPHONE: (661) 789-6944
LICENSING EVALUATOR SIGNATURE:	DATE: 10/04/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/04/2019

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
CCLD Regional Office, 1605 EAST PALMDALE BLV, STE A
PALMDALE, CA 93550

FACILITY NAME: KUSHNATSIAN FAMILY DAY CARE	FACILITY NUMBER: 197403536
	VISIT DATE: 10/04/2019

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The side portion of the backyard is used by the children for outside play. The far backyard is gated and locked to prevent child entry from all areas. The outdoor play area was inspected and play equipment was observed to be free of hazards, loose and sharp parts. There is a pool which is not accessible to children in care. Pool is blocked off by top locked sliding patio door from inside of the home and a locked gate from the outside. LPAs observed age appropriate toys at the home.

The facility’s fire extinguisher (2A10BC) met the State Fire Marshal standards. Licensee tested both the smoke and carbon monoxide detector and found both to be in operable condition. The facility annual fees are current. The parent board was reviewed and had all of the required forms posted and accessible to parents.

Children and staff files were reviewed and found to be complete. The facility roster and fire drills were up to date, and all individuals living the family child care home have been fingerprinted and associated to the facility. The licensee has a current CPR and Pediatric First Aid certification, which expires on 9-21-21. The licensee provided LPAs with proof of immunizations, and Mandated Reporter Certificate, which was obtained on 3/12/2018.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at http://www.ada.gov/childqanda.htm

The following were discussed:

There is an effective 24/7 ban on smoking tobacco in a home that is licensed as a family day care home, and in those areas of the family day care home where children are present. Baby walkers, baby jumpers, baby exercisers, baby bouncers/rockers and any other item that falls into that category are not permitted in the facility. The LPAs also discussed earthquake safety and necessity of drills, required forms for children’s files, facility files and posting requirements.

SUPERVISOR'S NAME: Claretta Yates	TELEPHONE: (661) 789-6944
LICENSING EVALUATOR NAME: Jesse Sims	TELEPHONE: (661) 789-6944
LICENSING EVALUATOR SIGNATURE:	DATE: 10/04/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/04/2019

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, 1605 EAST PALMDALE BLV, STE A
PALMDALE, CA 93550

FACILITY NAME: KUSHNATSIAN FAMILY DAY CARE	FACILITY NUMBER: 197403536
	VISIT DATE: 10/04/2019

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The licensee was informed that all adults living in or having access to the home are required to have fingerprint clearances with Department of Justice, FBI and Child Abuse Index prior to having contact with children. If the aforementioned is not adhered to, a Civil Penalty of up to $500, per non-cleared adult will be assessed immediately. Please advise your analyst of any person who will be visiting regularly or for longer than one week.

Beginning on January 1, 2018, Assembly Bill 1207 (2015) requires all licensed providers, applicants, directors and employees to complete training as specified on their mandated reporter duties and to renew their training every two years. Applicants must meet requirements as a precondition to licensure. New employees shall have 90 days from date of employment to complete training as required. The training may be conducted at the following website www.mandatedreporterca.com.

The licensee was reminded it is his/her responsibility to visit the departments website to obtain licensing forms, Quarterly Updates, and Provider Information Notices (PINs): www.ccld.ca.gov

Child Care Advocates:

To sign up for our Quarterly Updates please email the Child Care Advocates at
childcareadvocatesprogram@dss.ca.gov & (916) 654-1541.

The facility was in compliance per Title 22 regulations, and no deficiencies were cited today.

An exit interview was conducted, consultation provided and a copy of this report was read and provided to Licensee.

SUPERVISOR'S NAME: Claretta Yates	TELEPHONE: (661) 789-6944
LICENSING EVALUATOR NAME: Jesse Sims	TELEPHONE: (661) 789-6944
LICENSING EVALUATOR SIGNATURE:	DATE: 10/04/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/04/2019

LIC809 (FAS) - (06/04)

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