197493976-2-20-2025-58-CC-SGAN-DE3RBR-20250220115311

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197493976
Report Date: 02/20/2025
Date Signed: 02/20/2025 11:53:21 AM

Document Has Been Signed on 02/20/2025 11:53 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:	KEHIAIAN FAMILY CHILD CARE		FACILITY NUMBER:	197493976
ADMINISTRATOR/ DIRECTOR:	KEHIAIAN, ANI		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(818) 497-4948
CITY:	NORTH HOLLYWOOD	STATE: CA	ZIP CODE:	91606
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 10	CENSUS: 6	DATE:	02/20/2025
TYPE OF VISIT:	Required - 3 Year	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	08:15 AM
MET WITH:	Ani Kehiaian, Licensee		TIME VISIT/ INSPECTION COMPLETED:	11:55 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	Licensing Program Analyst (LPA) Silva Garibyan conducted a site visit for the purpose of a Required- 3 year visit. LPA met with the licensee and toured the home inside and outside. Licensee was present with six children and two assistants. The licensee's home is a single story 3 bedroom, 2 bathroom home with living room, kitchen, dining area, Family/playroom, and attached garage. Main care is provided in the Family/playroom, Bedroom (1) (including two step down area), and Bedroom( 2). Children eat in the Family/Playroom and nap in Bedroom (1) and Bedroom (2). Children use Bathroom(1) in the hall way. The attached garage if off limits to the children in care. LPA toured the home inside and outside and a census was taken. Current facility sketch reviewed. LPA confirmed with licensee off limits rooms identified on facility sketch. All rooms identified as off limits were made inaccessible by locked doors and child safety knobs. Stove knobs has child safety knobs. There is no swimming pool or other bodies of water on the premises. There are no firearms or ammunition on the premises. All poisons are kept in a locked storage area. No poisons were observed during the inspection. detergents, cleaning compounds, medication and other hazardous items are made inaccessible. The fireplace located in the living room and is made inaccessible by a screen, glass door and child safety lock. The fire place will not be used during day-care hours. There is a working fire extinguisher (Service Date: 10/17/2024), smoke detector, carbon monoxide detector and adequate heating and ventilation for safety and comfort. The required fire extinguisher (2A 10BC) and smoke and carbon monoxide detectors are in operable condition. There are no stairs in this home. Toys are safe and play equipment observed. The home has working telephone service and LPA confirmed the phone number is (818) 497-4948. Page 1

Betty Bell	TELEPHONE: (424) -301-3063
Silva Garibyan	TELEPHONE: (424) 301-3062
	DATE: 02/20/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/20/2025

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: KEHIAIAN FAMILY CHILD CARE	FACILITY NUMBER: 197493976
	VISIT DATE: 02/20/2025

NARRATIVE

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Individuals residing in the home have been discussed and noted. All adults present in the home have obtained a criminal record clearance or exemption. The bathroom and the kitchen was observed free of chemicals or toxic items that can pose danger to children in care.
Family/Playroom observed to have three children size tables, 14 children size chairs, three high chairs, variety of age appropriate materials. Bedroom (1) observed to have nine cots and Bedroom (2) observed to have two cribs. The outdoor play area was inspected. Children's outdoor play equipment and toys are age appropriate and in good repair.
LPA also observed Licensee's and Assistants' current Pediatric CPR (Adult/Infant /Child) and Pediatric First Aid certifications (licensee's expires 12/2026) and Licensee's and Assistants' Mandated Reporter Training Certifications(licensee completed 02/24/2024). The fire drills are done every month. Last drill was conducted in January. Licensee provides meals and snacks. LPA discussed food preparation, storage and ensuring a log and information regarding dietary restrictions and allergies are kept up to date. Licensee stated that a cell phone with active service in the home will be the main contact number while children are in care.

LPA observed in the Family/Playroom 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 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.

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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: 02/20/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/20/2025

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: KEHIAIAN FAMILY CHILD CARE	FACILITY NUMBER: 197493976
	VISIT DATE: 02/20/2025

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.

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.

There are no infants 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.

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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: 02/20/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/20/2025

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: KEHIAIAN FAMILY CHILD CARE	FACILITY NUMBER: 197493976
	VISIT DATE: 02/20/2025

NARRATIVE

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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.

During the exit interview, the licensee Ani Kehiaian informed 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 licensee Ani Kehiaian.

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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: 02/20/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/20/2025

LIC809 (FAS) - (06/04)

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