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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197494533
Report Date: 11/16/2021
Date Signed: 11/16/2021 01:19:53 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:MELIKYAN & HARUTYUNOVA FAMILY CHILD CAREFACILITY NUMBER:
197494533
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 6DATE:
11/16/2021
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
11:58 AM
MET WITH:M & Harutyunova Family Child CareTIME COMPLETED:
01:25 PM
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On 11/16/2021 Licensing Program Analyst (LPA) Laticia Thompson conducted an unannounced case management visit to inspect a body of water (swimming pool). LPA met with licensee Lusine Harutyunova. LPA observed 2 adults and 6 children. LPA toured the backyard area of the facility and inspected the backyard pool area. Based on the guidance of the Child Care Licensing Body of Water Evaluation checklist LPA observed the following corrections to be made:

A portion of the fencing height is 4 feet 10 inches from the bottom of the gate to the top of the gate. The portions of the gate that does not meet the 5 feet requirement are located at the entrance of the gate next to the play yard area and the back door exit of the home were the sliding back door is located.

Plan of Correction

Licensee will add additional bars to the gate to increase the height to 5 feet by 11/20/2021.

The pool is currently empty due to an upgrade to the painting. Licensee ensures that the pool will be filled with water by 11/20/2021.
SUPERVISOR'S NAME: Peter FloresTELEPHONE: (424) 301-3077
LICENSING EVALUATOR NAME: Laticia S ThompsonTELEPHONE: (424) 301-3048
LICENSING EVALUATOR SIGNATURE:

DATE: 11/16/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/16/2021
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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