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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197419194
Report Date: 02/03/2023
Date Signed: 02/03/2023 02:43:51 PM


Document Has Been Signed on 02/03/2023 02:43 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
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551



FACILITY NAME:AVETISIAN FAMILY CHILD CAREFACILITY NUMBER:
197419194
ADMINISTRATOR:AVETISIAN, ELIZABETHFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(323) 829-1948
CITY:SYLMARSTATE: CAZIP CODE:
91342
CAPACITY:14CENSUS: 8DATE:
02/03/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:35 PM
MET WITH:Elizabeth AvetsianTIME COMPLETED:
02:57 PM
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Licensing Program Analyst (LPA's) Justin Dorsey and Kris Diaz met with Licensee, Elizabeth Avetsian, who guided analyst on a tour of the facility for the One Year Required Inspection. Also present during the inspection was Spouse #1 who aided the licensee with the visit. This is a two story 4 bedroom, 3 bathroom home with living room, dining room, kitchen, playroom, laundry room and garage. There is no pool on the premises. Upon arrival LPA's observed 8 children with the licensee, Spouse #1 and Assistant #1.

Physical Plant: Main care is provided in the dining room, living room and playroom. Children use the bathroom in hallway near the homes laundry room. Children have access to the playroom, dining room, living room, children's bathroom and backyard. Off limit areas include the homes entire upstairs, downstairs bedroom, laundry room, and garage. The home was inspected inside and out for safety, comfort, cleanliness, telephone service, heating and ventilation, inaccessibility to poisons, detergents/cleaning compounds (stored inaccessible in laundry room), medicines (inaccessible in laundry room) and hazardous items (sharp knives inaccessible in locked kitchen drawer) that can pose a danger to children. The home has safe and age appropriate toys, play equipment and materials. The smoke detector and carbon monoxide detector, and Fire Extinguisher (2A10BC) are in operable condition. Per Licensee no one smokes in the home. Electrical outlets are inaccessible. There is a designated area for ill children as necessary in living room. Per Licensee there are no weapon/firearms in the home. While touring the playroom LPA's observed a baby walker, per licensee the baby walker was her grand daughters. During the visit the walker was moved to an off-limits area of the home. LPA's advised licensee that the walker can not be used while children are in care. During the visit LPA's observed the home had an electric fire place with an open face heater that wasn't barricaded. During the visit the licensee screened the fireplace with a temporary barricade. LPA's advised licensee to get a permanent barricade for the heater. Per licensee she will send LPA Dorsey a picture of the fireplace when it is permanently barricaded or moved.

The last fire/earthquake drill was completed 02/02/23. Roster complete and maintained current.
SUPERVISOR'S NAME: Claretta YatesTELEPHONE: (661) 202-3318
LICENSING EVALUATOR NAME: Justin DorseyTELEPHONE: (661) 305-3012
LICENSING EVALUATOR SIGNATURE:
DATE: 02/03/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/03/2023
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
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: AVETISIAN FAMILY CHILD CARE
FACILITY NUMBER: 197419194
VISIT DATE: 02/03/2023
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Bathroom: Shower/tub are free of hazards (child care bathroom). Toilet and faucet is clean and operable.

Kitchen: Sharp utensils are inaccessible. Per licensee breakfast, AM snack, lunch, and PM snack are provided. LPA reminded licensee If food is brought from the children’s home, the container shall be labeled with the child’s name and properly stored or refrigerated. Cleaning supplies are stored inaccessible to children in the laundry room. No chemicals in the kitchen were observed to be accessible.

Outdoor: The backyard is safe for children and completely fenced. The children have access to the upper area of the backyard. There is a padded walk way which children can walk to the on-limits outdoor play area. In this play area there is a jungle gym with swings and a teeter totter. LPA's reminded licensee that age requirement (3-10 years old) for this equipment must be followed. The children's play area has rubber mulch (under climbing equipment) and concrete areas for children to play. LPA's observed the toys in the backyard to be in safe condition.

Advisory/Other: First Aid kit was readily available. CPR/First Aid expire 09/2024 for all staff present. Mandated Reporter for was completed on 01/12/2023. Children nap on mats in the dining room and play room.

Documents discussed: Safe Sleep PIN 20-24-CCP, LIC 9227 and Infant Sleep Log.

Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, 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 up to $500.00 maximum per day/per person will be assessed if this regulation is violated.
SUPERVISOR'S NAME: Claretta YatesTELEPHONE: (661) 202-3318
LICENSING EVALUATOR NAME: Justin DorseyTELEPHONE: (661) 305-3012
LICENSING EVALUATOR SIGNATURE:

DATE: 02/03/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/03/2023
LIC809 (FAS) - (06/04)
Page: 2 of 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: AVETISIAN FAMILY CHILD CARE
FACILITY NUMBER: 197419194
VISIT DATE: 02/03/2023
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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 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.

A notice of site visit was given and must remain posted for 30 days.

Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with the licensee Elizabeth Avetsian.

SUPERVISOR'S NAME: Claretta YatesTELEPHONE: (661) 202-3318
LICENSING EVALUATOR NAME: Justin DorseyTELEPHONE: (661) 305-3012
LICENSING EVALUATOR SIGNATURE:

DATE: 02/03/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/03/2023
LIC809 (FAS) - (06/04)
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