197417725-7-23-2021-30-CC-DADS-C57U5G-20210723151641

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197417725
Report Date: 07/23/2021
Date Signed: 07/23/2021 03:17:37 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME:	HARUTYUNYAN FAMILY CHILD CARE		FACILITY NUMBER:	197417725
ADMINISTRATOR:	ANGELINA HARUTYUNYAN		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(818) 515-4878
CITY:	VAN NUYS	STATE: CA	ZIP CODE:	91405
CAPACITY:	14	CENSUS: 13	DATE:	07/23/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	11:40 AM
MET WITH:	Angelina Harutyunya		TIME COMPLETED:	03:20 PM

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On July 23 at 9:40am Licensing Program Analyst (LPA), Dalicia Adkins conducted an unannounced Annual Required Inspection and was met by Licensee, Angelina Harutyunyan.Days and hours of operation are 8:00am - 8:00pm.

LPA toured the home inside and outside and a census was taken. Current facility sketch reviewed, and Licensee confirmed that the kitchen, bathroom and living room are used for providing care and are accessible to children. All other rooms are off-limits and made inaccessible by use of locked doors. There is no swimming pool, LPA observed temporarily inflatable play water slide that was rented today in celebration of a child's birthday. Children were observed to be well supervised during water play. Before leaving the facility water slide was deflated and no bodies of water observed. There are no firearms or ammunition on the premises. All poisons are kept in a locked storage area. Detergents, cleaning compounds, medication and other hazardous items are made inaccessible.

There are no fireplaces'. LPA observed non-working face heaters in the home. Per licensee face heater is disconnected and has not worked in 10 years. Per licensee the room is temperature is controlled by central heat and air conditioning system. LPA observed central heating/Air conditioning unit mounted on the wall in the living room area. Licensee wrote statement about non-operation of the wall heater. There is a working fire extinguisher, smoke detector, carbon monoxide detector and adequate heating and ventilation for safety and comfort. There are no stairs in this home. Safe toys and play equipment observed. The home has working telephone service and LPA confirmed the phone number is (818) 515-4878.

There are currently no infants in care. LPA discussed Safe Sleep Regulations with licensee.

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SUPERVISOR'S NAME: Karren Starks	TELEPHONE: (424) -30-3038
LICENSING EVALUATOR NAME: Dalicia Adkins	TELEPHONE: (424) 301-3064
LICENSING EVALUATOR SIGNATURE:	DATE: 07/23/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/23/2021

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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: HARUTYUNYAN FAMILY CHILD CARE	FACILITY NUMBER: 197417725
	VISIT DATE: 07/23/2021

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LPA discussed Safe Sleep Regulations with licensee.

Licensee ensures that children in care are supervised at all times and is aware children shall not be left in parked vehicles. Car seats are used for transportation purposes only and are not used for sleeping children. The outdoor play area in the backyard is fenced and there are no hazards to children present. Capacity as specified on the license is being maintained.

LPA reviewed a sample of children’s files and observed files were complete with emergency information as required. Licensee is currently enrolled in Mandated Reporting class, registered on 7/12/2021 and need to complete the test. Per licensee test will be completed and submitted via email by Monday 7/26/2021. Licensee provided LPA with receipt of Mandated Reporting Class. Licensee’s pediatric CPR/First Aid expires on August 06/2023. A review of records indicates that all employees and/or volunteers have immunization records on file for influenza, pertussis and measles.

All adults who reside or work in the home have a criminal record clearance or exemption. There are no excluded individuals present at this home.

Incidental Medical Services (IMS) not currently being provided. Licensee is aware that an IMS plan is required to be submitted to the licensing office if they provide any of these services. Information regarding Americans with Disability Act (ADA) can be obtained by contacting US Department of Justice toll free ADA Information line at (800) 514-0301(voice), (800) 514-0383 (TDD) and website link https://www.ada.gov/childqanda.htm.

LPA and Licensee discussed the Community Care Licensing website www.ccld.ca.gov which will provide access to Provider Information Notices (PINs), Quarterly Updates, COVID-19 Information and Resources, Mandated Reporter Training, Safe Sleep in Child Care, Lead Poisoning Facts, Forms and Regulations.

Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, no deficiencies are cited.

This report shall be made available to the public upon request. LIC 9213 Notice of Site Visit is provided and required to be posted for 30 days.

LPA off facility premises from 12:20 PM- 1:40 PM - report documentation and printing.

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SUPERVISOR'S NAME: Karren Starks	TELEPHONE: (424) -30-3038
LICENSING EVALUATOR NAME: Dalicia Adkins	TELEPHONE: (424) 301-3064
LICENSING EVALUATOR SIGNATURE:	DATE: 07/23/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/23/2021

LIC809 (FAS) - (06/04)

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