197493006-10-8-2020-12-CC-MRAN-BUBNZ5-20201012105344

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197493006
Report Date: 09/25/2020
Date Signed: 10/08/2020 10:13:36 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

This is an official report of an unannounced visit/investigation of a complaint received in our office on
07/27/2020 and conducted by Evaluator Monique Jessica Ayala

PUBLIC

COMPLAINT CONTROL NUMBER: 12-CC-20200727132206

FACILITY NAME:	POGHOSYAN FAMILY CHILD CARE		FACILITY NUMBER:	197493006
ADMINISTRATOR:	POGHOSYAN, LARISSA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(818) 442-2424
CITY:	NEWHALL	STATE: CA	ZIP CODE:	91321
CAPACITY:	14	CENSUS: 6	DATE:	09/25/2020
		UNANNOUNCED	TIME BEGAN:	03:00 PM
MET WITH:	Larissa Poghosyan, Licensee		TIME COMPLETED:	04:00 PM

ALLEGATION(S):

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Personal Rights: Child sustained unexplained injuries while in care.

INVESTIGATION FINDINGS:

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This report was Amended by Licensing Program Analyst (LPA) Monique Ayala on 10/07/2020 to correct prior report issue. The initial visit was conducted 09/25/2020 via tele-visit due to COVID-19.

On 09/25/2020 at 3:00 PM LPA, Monique Ayala spoke with Licensee, Larissa Poghosyan to deliver the findings for the above allegation. The investigation consisted of interviews conducted with Licensee, Licensee’s staff, children, and other relevant complaint parties. The interviews revealed that there were no witnesses that could corroborate child sustained a minor scratch on lower lip and a minor scratch on the head while at the facility. Licensee and staff at the facility denied child sustained the injuries while at the facility. Based on the evidence obtained the above allegation is deemed unsubstantiated.

This inspection visit was conducted via Tele-visit, the report was read and has been emailed for read receipt.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Mariela Ramon	TELEPHONE: (661) 369-2168
LICENSING EVALUATOR NAME: Monique Jessica Ayala	TELEPHONE: (661) 202-3365
LICENSING EVALUATOR SIGNATURE:	DATE: 09/25/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/25/2020

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

LIC9099 (FAS) - (06/04)

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