197419437-4-3-2024-58-CC-SGAN-D3YPGC-20240403111806

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197419437
Report Date: 03/29/2024
Date Signed: 04/03/2024 11:19:17 AM

Document Has Been Signed on 04/03/2024 11:19 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:	HOVANISYAN, AVAGYAN FAMILY CHILD CARE		FACILITY NUMBER:	197419437
ADMINISTRATOR:	ANAHIT HOVANISYAN; KARINE		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(323) 580-7709
CITY:	NORTH HOLLYWOOD	STATE: CA	ZIP CODE:	91606
CAPACITY:	14	CENSUS: 7	DATE:	03/29/2024
TYPE OF VISIT:	Required - 3 Year	UNANNOUNCED	TIME BEGAN:	07:30 AM
MET WITH:	Karine Avagyan & Anahit Hovanisyan, Licensees		TIME COMPLETED:	11:25 AM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	Required Visit Conducted In Armenian Licensing Program Analyst (LPA) Silva Garibyan conducted a site visit for the purpose of an Annual Required visit . LPA met with the licensees and toured the home inside and outside at 7:45 a.m on 04/03/2024. There were seven children present at the time of the visit. The licensees' home is a single story 3 bedroom, 2 bathroom home with living room, dining room, kitchen, den and detached garage with added storage room. The garage is used for storage only and there is a safety device on the door knob, preventing access. The main garage door is accessible from the alley only. There is no pool, spa or other bodies of water on the premises. Family members residing in the home at this time include 2 adults (licensees) and no children. Main care is provided in the living room and the bedroom/play room accessible from the hallway. Children eat, nap and play in the living room and in Bedroom 1. Children have access to the bathroom accessible from the hallway on the left side of the home. Children play in the enclosed rear yard and cemented side yard. Off limit areas include the home's two bedrooms, one bathroom located inside a bedroom, and the garage. These bedrooms have safety devices on the door knobs, making the contents of the rooms inaccessible. LPA observed tables, chairs and napping equipment. The main entry door is used to enter the facility. Licensees report they have no firearms or weapons in the home. LPA did not observe any weapons. Page 1 of 4

SUPERVISOR'S NAME: Betty Bell	TELEPHONE: (424) -301-3063
LICENSING EVALUATOR NAME: Silva Garibyan	TELEPHONE: (424) 301-3062
LICENSING EVALUATOR SIGNATURE:	DATE: 03/29/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/29/2024

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: HOVANISYAN, AVAGYAN FAMILY CHILD CARE	FACILITY NUMBER: 197419437
	VISIT DATE: 03/29/2024

NARRATIVE

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The LPA toured all areas used by children during this inspection. The bathroom in the hall way and the kitchen was observed free of chemicals or toxic items that can pose danger to children in care. Children play in the back yard. LPA observed the yard to be clean, free of debris, and fully fenced. All electrical outlets in the home were covered. The outdoor play area/back yard was inspected. Children's outdoor play equipment and toys are age appropriate and in good repair. The Fire Extinguisher (2A-10-BC) is mounted on the wall in the kitchen. There is a working smoke and carbon monoxide detectors located in the living room. The First Aid kit was observed, and complete. LPA observed the fire drill log. The fire drills are done every six months. The licensees have current Mandated Reporter (completed on 03/19/2024) and current pediatric CPR/First Aid training (completed on 02/08/2024). Licensees provide meals and snacks. LPA discuss food preparation, storage and ensuring a log and information regarding dietary restrictions and allergies are kept up to date. Licensees stated that a cell phone with active service in the home will be the main contact number while children are in care.

LPA observed by the entrance the Parent Board with all necessary posting required ( Facility License (LIC 203), Emergency Disaster Plan (LIC610A), Notification of Parents' Rights Poster (PUB 394), If You see Something Say Something poster, Car Seat Safety poster). Child Care Facility Roster (LIC9040) was on file.
A review of the children's records was conducted and are found to have the following: LIC 282 Affidavit Liability Insurance, LIC 627/Consent for Medical Treatment, LIC 700/ID and Emergency Information, LIC702, LIC 995A/Parent's Rights, LIC995E/Caregiver Background Check, LIC 9150/Parent Notification, LIC 9212/Parent's Responsibilities, PM 286/Immunization Card. Page 2 of 4

SUPERVISOR'S NAME: Betty Bell	TELEPHONE: (424) -301-3063
LICENSING EVALUATOR NAME: Silva Garibyan	TELEPHONE: (424) 301-3062
LICENSING EVALUATOR SIGNATURE:	DATE: 04/03/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/03/2024

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: HOVANISYAN, AVAGYAN FAMILY CHILD CARE	FACILITY NUMBER: 197419437
	VISIT DATE: 03/29/2024

NARRATIVE

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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.

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.

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.

No infants are enrolled at this time. LPA discussed the safe sleep regulations with licensees 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. Page 3 of 4

SUPERVISOR'S NAME: Betty Bell	TELEPHONE: (424) -301-3063
LICENSING EVALUATOR NAME: Silva Garibyan	TELEPHONE: (424) 301-3062
LICENSING EVALUATOR SIGNATURE:	DATE: 04/03/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/03/2024

LIC809 (FAS) - (06/04)

Page: 3 of 4

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: HOVANISYAN, AVAGYAN FAMILY CHILD CARE	FACILITY NUMBER: 197419437
	VISIT DATE: 03/29/2024

NARRATIVE

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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.

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/.

Licensees were 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.
During the exit interview, the licensees Karine Avagyan and Anahit Hovanisyan, confirmed that there are no Registered Sex Offenders living in the facility.
A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the licensees Karine Avagyan and Anahit Hovanisyan.

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SUPERVISOR'S NAME: Betty Bell	TELEPHONE: (424) -301-3063
LICENSING EVALUATOR NAME: Silva Garibyan	TELEPHONE: (424) 301-3062
LICENSING EVALUATOR SIGNATURE:	DATE: 04/03/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/03/2024

LIC809 (FAS) - (06/04)

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