<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197494888
Report Date: 10/04/2021
Date Signed: 10/04/2021 03:54:02 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:PEPANYAN FAMILY CHILDCAREFACILITY NUMBER:
197494888
ADMINISTRATOR:ZHANNA PEPANYANFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(818) 645-5444
CITY:NORTHRIDGESTATE: CAZIP CODE:
91325
CAPACITY:14CENSUS: 0DATE:
10/04/2021
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
12:54 PM
MET WITH:Zhanna PepanyanTIME COMPLETED:
02:35 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
Margarit Sislyan, Licensing Program Analyst (LPA) arrived at the facility to observe the required corrections before the licensure.

The following corrections were observed:

The large sized china cabinet was mounted to the wall.

The child proof latches were installed on the kitchen cabinet doors.

LPA observed the play equipment was removed from the property.

All adults residing in the house had criminal record clearance. LIC508 and TB clearance for each adult had been submitted to CCLD.

The license for Large Family Child Care will be granted.

Exit interview
SUPERVISOR'S NAME: Mary RuizTELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Margarit SislyanTELEPHONE: (424) 430-3049
LICENSING EVALUATOR SIGNATURE:

DATE: 10/04/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/04/2021
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 1