197420060-4-3-2023-58-CC-SORS-CQJV3A-20230403160426

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197420060
Report Date: 04/03/2023
Date Signed: 04/03/2023 04:04:37 PM

Document Has Been Signed on 04/03/2023 04:04 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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME:	HARUTYUNYAN FAMILY CHILD CARE		FACILITY NUMBER:	197420060
ADMINISTRATOR:	HARUTYUNYAN, TEHMINE		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(818) 219-0626
CITY:	VAN NUYS	STATE: CA	ZIP CODE:	91405
CAPACITY:	14	CENSUS: 7	DATE:	04/03/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	01:30 PM
MET WITH:	HARUTYUNYAN, TEHMINE- Licensee		TIME COMPLETED:	04:30 PM

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	On 4/3/2023, Licensing Program Analyst (LPA), Suzette Ornelas conducted an unannounced Annual Required Inspection and was met by Licensee, Themine Harutunyan. Also present was Licensees Assistant. Days and hours of operation are Monday through Friday 8am-5pm. LPA toured the home inside and outside and a census was taken. LPA observed 7 children and 0 infants in care. Current facility sketch reviewed and all areas identified on the facility sketch were inspected. Licensee's home is a one story dwelling with 2 bedrooms and, 2 bathrooms. Children in care have access to the bathroom located next to the off limits master bedroom. Child care is provided mainly in the classroom (living room), playroom (room at the far end of the home) and bedroom 1 which has an attached off limits restroom. Children eat in the playroom. All other rooms are off-limits and made inaccessible by use of supervision, safety gates and closed/locked doors. Children have access to the front yard for activities, the back yard and side of the home have been made inaccessible by a latched gate. The Fire Extinguishers (2A-10-BC) is mounted on the wall in the kitchen with a service date of August 8, 2022. There is a working smoke/carbon monoxide detector located in the children’s classroom. Due to Malfunction while attempting to test, Licensee will be purchasing a new Carbon Monoxide Detector and will send LPA a video once installed on or before 4/4/2023. 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. The First Aid kit was observed and complete. Per LIS the facility annual fees are current. The facility roster was observed, and current. There are age appropriate toys and napping equipment on the premises. Licensee has posted as required the License, and all other required postings in a visible location. There are no firearms or ammunition on the premises. There is no swimming pool or other bodies of water on the premises. There is no fireplace in the home

SUPERVISOR'S NAME: Lisa Rios	TELEPHONE: (424) 301-3072
LICENSING EVALUATOR NAME: Suzette Ornelas	TELEPHONE: 424-301-3008
LICENSING EVALUATOR SIGNATURE:	DATE: 04/03/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/03/2023

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)

Page: 1 of 3

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: HARUTYUNYAN FAMILY CHILD CARE	FACILITY NUMBER: 197420060
	VISIT DATE: 04/03/2023

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
26
27
28
29
30
31
32

There are currently 0 infants in care. LPA discussed Safe Sleep Regulations with licensee and provided a copy of the Infant Safe Sleep Regulation, a sample of an infant safe sleep log, a copy of the LIC 9227, and Frequently Asked Questions regarding Infant Safe Sleep packet. 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 is fenced and remains locked while children are in care and there are no hazards to children present. LPA discussed the importance of ensuring that outdoor equipment is regularly inspected, dusted off as needed and removed if broken.

Capacity as specified on the license is being maintained. LPA reviewed 5 children's records and observed records were complete. An emergency fire/disaster drill has been completed and documented within the last 6 months. Licensee and Assistants pediatric CPR/First Aid is current. Licensee Mandated Reporter Training is current; however, assistants/mothers is not. Per licensee, assistant/mother does not speak English but she has explained the requirements to her assistant/mother. LPA explained that all adults require to take training and provided licensee with information on assisting with translation while assistant/mother is taking the training. LPA reminded licensee that the Mandated Reported Training is required to be completed every two years. 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) are 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 being cited.

SUPERVISOR'S NAME: Lisa Rios	TELEPHONE: (424) 301-3072
LICENSING EVALUATOR NAME: Suzette Ornelas	TELEPHONE: 424-301-3008
LICENSING EVALUATOR SIGNATURE:	DATE: 04/03/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/03/2023

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

FACILITY NAME: HARUTYUNYAN FAMILY CHILD CARE	FACILITY NUMBER: 197420060
	VISIT DATE: 04/03/2023

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 26 27 28 29 30 31 32	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. suzette.ornelas@dss.ca.gov

SUPERVISOR'S NAME: Lisa Rios	TELEPHONE: (424) 301-3072
LICENSING EVALUATOR NAME: Suzette Ornelas	TELEPHONE: 424-301-3008
LICENSING EVALUATOR SIGNATURE:	DATE: 04/03/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/03/2023

LIC809 (FAS) - (06/04)

Page: 3 of 3