197418189-2-26-2025-58-CC-ECAO-DE9QVY-20250226113108

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197418189
Report Date: 02/26/2025
Date Signed: 02/26/2025 11:32:13 AM

Document Has Been Signed on 02/26/2025 11:32 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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME:	MELKUMYAN FAMILY CHILD CARE		FACILITY NUMBER:	197418189
ADMINISTRATOR/ DIRECTOR:	MELKUMYAN, ANUSH		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(818) 923-5159
CITY:	GRANADA HILLS	STATE: CA	ZIP CODE:	91344
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 4	CENSUS: 3	DATE:	02/26/2025
TYPE OF VISIT:	Required - 3 Year	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	09:05 AM
MET WITH:	Anush Melkumyan, Licensee		TIME VISIT/ INSPECTION COMPLETED:	12:00 PM

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On 02/26/2025, Licensing Program Analyst (LPA) Elicia Calvillo conducted an unannounced 3 Year Required Annual inspection at 15907 Harvest Street, Granada Hills, CA. 91344. LPA arrived at the facility at 09:05 AM, identified self and met with Anush Melkumyan, Licensee, who guided analyst on a tour of the inside and outside of the facility. There were 3 children present at arrival. LPA provided Licensee with a copy of the LIC125 Entrance Checklist -Family Child Care Homes to help facilitate the inspection. Licensee cares for children from ages 0 years to 15 year olds. Facility hours of operation are Monday to Friday from 06:00AM to 05:00PM.

The licensee provided proof of control of property.

The family child care home is a one story dwelling, includes living room, dining room, kitchen, play room, laundry nook, 3 bathrooms, 3 bedrooms, and no garage. There is a front yard that is off limits to children. There is a fenced outdoor play area on the side and back of the house.

All areas identified on the facility sketch that are accessible for children to use were inspected for safety, comfort, and cleanliness. The children use the Play Room for child care activities, sleeping, and eating. There are tables and chairs, toys and play items that are safe, clean, and appropriate for the ages of the children. There are cots and bed linens available for children.

The children use the bathroom #1 in the Play Room. The vanity cabinet holds hand soap and paper products, and no hazards were observed. LPA observed that the bathroom that children use was safe and sanitary.

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Rita Ramos
Elicia Calvillo
	DATE: 02/26/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/26/2025

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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

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

FACILITY NAME: MELKUMYAN FAMILY CHILD CARE	FACILITY NUMBER: 197418189
	VISIT DATE: 02/26/2025

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Per Licensee, when a child shows signs of illness they will be separated from other children and isolated in the Play Room away from other children.

The kitchen is made inaccessible with the use of door with a lock. The licensee provides food for children in care. Licensee stated when food is brought to the facility it is labeled with child’s name and stored properly. There is telephone service via a cellphone that stays at the facility during the hours of operation.

The outdoor play area is located at the side of the house and the back yard of the house, is fenced and there are no hazards to children present. LPA observed appropriate toys, swing, and other play equipment for children in care. LPA observed a swing set that is secured to the ground and the ground underneath and around is covered with grass to absorb falls. LPA observed adequate shade with a covered patio.

Per Licensee, areas off limits to children and parents include living room, dining room, kitchen, 3 bedrooms, 2 bathroom and laundry nook and are made inaccessible by use of door with a lock to the only entrance to those area.

LPA did observe a front yard, per Licensee, the front yard is not used for child care activities and is used for dropping off and picking up children. Children enter the child care through the Play Room from a side door located on the side of the house which has a gate.

Per Licensee, there are no firearms, ammunition, or poisons on the premises. LPA did not observe any firearms, ammunition, or poisons during the inspection. Poisons, detergents, cleaning compounds, medicines, firearms, and other items which could pose a danger if readily available to children are stored where they are inaccessible to children.

Per Licensee, there are no pets on the premises. LPA did not observe any pets on the premises.

LPA did not observe a fireplace or an open face heater during the inspection. There is a working fire extinguisher, the valve on the required 2A 10BC fire extinguisher indicates fully charged and Licensee confirmed last service date. There is a combination smoke / carbon monoxide detector located in the Play room and was tested and are operable.

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SUPERVISOR'S NAME: Rita Ramos
LICENSING EVALUATOR NAME: Elicia Calvillo
LICENSING EVALUATOR SIGNATURE:	DATE: 02/26/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/26/2025

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

FACILITY NAME: MELKUMYAN FAMILY CHILD CARE	FACILITY NUMBER: 197418189
	VISIT DATE: 02/26/2025

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There are currently infants in care. LPA discussed the safe sleep regulations with Licensee and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA discussed that an Individual Infant Sleeping Plan [LIC 9227 (3/20)] shall be completed for each infant up to 12 months of age the Licensee has in care and included in the infant's file at the facility. LPA discussed with Licensee that documentation shall be maintained in the infant’s file and available for the Department to review. The documentation shall include the following: date, infants name, and the time of each 15-minute check.

LPA also informed Licensee of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

LPA did not observe the following items during the inspection: Infant Walkers, Johnny Jumpers, Saucer Chairs, Trampolines and/or any other item that fall into these categories are not permitted in a family child care facility.

Licensee was reminded that children in care are to be supervised at all times and made aware that children shall not be left in parked vehicles. Car seats shall only be used for transportation purposes and shall not be used for sleeping.

Capacity as specified on the license is being maintained.

Emergency Disaster Plan, Parent’s Rights Poster and the Facility License were observed to be posted.

LPA reviewed a sample of children’s files and observed files were complete and documented on the LIC857.

An emergency fire/disaster drill has been completed and documented within the last 6 months on 01/07/2025. Licensee’s Mandated Reporter Training was completed on 02/25/2025. Licensee’s pediatric CPR/First Aid expires on 01/2026.

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SUPERVISOR'S NAME: Rita Ramos
LICENSING EVALUATOR NAME: Elicia Calvillo
LICENSING EVALUATOR SIGNATURE:	DATE: 02/26/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/26/2025

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

FACILITY NAME: MELKUMYAN FAMILY CHILD CARE	FACILITY NUMBER: 197418189
	VISIT DATE: 02/26/2025

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There were no personnel record for LPA to review due to low enrollment.

LPA reviewed with licensee the LIC 311D, Forms/Records to Keep In Your Family Child Care Homes, children's forms/records, facility forms/records, and information to be posted.

During the exit interview, the Licensee, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

Smoking is prohibited in a licensed Family Child Care Home. Per Licensee, no one smokes in the home.

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.

Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. 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: https://www.ada.gov/resources/child-care-centers/.

Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

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SUPERVISOR'S NAME: Rita Ramos
LICENSING EVALUATOR NAME: Elicia Calvillo
LICENSING EVALUATOR SIGNATURE:	DATE: 02/26/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/26/2025

LIC809 (FAS) - (06/04)

Page: 4 of 5

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

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

FACILITY NAME: MELKUMYAN FAMILY CHILD CARE	FACILITY NUMBER: 197418189
	VISIT DATE: 02/26/2025

NARRATIVE

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Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platforms.

To receive important licensed related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care licensing/subscribe and select the Child Care option to receive email communication.

To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, there are no citations being cited today.

A Notice of Site Visit was given and must remain posted for 30 days during the hours of operation after each site visit by a licensing representative. Failure to comply with posting requirement will result in an immediate civil penalty of $100.00.

Exit interview was conducted with Anush Melkumyan, Licensee including, but not limited to Provider Rights, Appeal Procedures and Agencies Consultative Role.

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SUPERVISOR'S NAME: Rita Ramos
LICENSING EVALUATOR NAME: Elicia Calvillo
LICENSING EVALUATOR SIGNATURE:	DATE: 02/26/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/26/2025

LIC809 (FAS) - (06/04)

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