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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197494931
Report Date: 04/22/2022
Date Signed: 04/25/2022 10:48:40 AM


Document Has Been Signed on 04/25/2022 10:48 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
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245



FACILITY NAME:GAVALJYAN FAMILY CHILD CAREFACILITY NUMBER:
197494931
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 4DATE:
04/22/2022
TYPE OF VISIT:Case Management - OtherANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Anahit GavaljyanTIME COMPLETED:
03:00 PM
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On 4/22/2022 Licensing Program Analyst (LPA) Judy Laureano conducted an announced inspection with applicants Anahit Gavaljyan for the purpose of an increase of capacity inspection of 6607 Gazette Avenue, Winnetka, CA 91306. The purpose of this inspection is to ensure the standards for a Family Child Care Home are being met in accordance to California Tittle 22 Regulations and California Health and Safety Codes.

The licensee is applying for an increase of capacity; Large Family Child Care Home license for a max capacity of 14. A fire clearance was approved by LA County Fire Department on 4/5/2022. Facility was licensed for a Small (8) Family Child Care Home on 8/29/2018.

The capacity of the Large Family Child Care Home is 14. Per the application, at this time, the ages the applicant wishes to provide services for are children birth to12 years old with the hours of Monday- Friday from 8:00 a.m. to 9:00 p.m. Licensee was informed that any changes to ages, hours and days of operation shall be submitted to the department for approval prior to initiation of changes.

Copy of mortgage statement is currently on file reflecting control of property. Currently living in the home is only the applicant. Home is located on a lot with a front house with address: 6609 Gazette Avenue, Winnetka, CA 91306- a separate house with separate tenants. Certificate of Occupancy for facility is currently on file for 6607 Gazette Avenue.

The home is a back unit with 1 bedroom, 1 bathroom, 1 kitchen and living room/dining room. The home has a back yard that has been designated for the use of the daycare.

Parents will access the home through the side entrance. Entering the home, you are led to a cemented driveway that lead to the backyard. Facility uses a ring camera doorbell that allows gate to be locked at all times.

SUPERVISOR'S NAME: Claudia EscobedoTELEPHONE: (424) 301-3044
LICENSING EVALUATOR NAME: Judy LaureanoTELEPHONE: (424) 301-3060
LICENSING EVALUATOR SIGNATURE:
DATE: 04/22/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/22/2022
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
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: GAVALJYAN FAMILY CHILD CARE
FACILITY NUMBER: 197494931
VISIT DATE: 04/22/2022
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Entering the home you are led to the living room/dining room area that has been designated for the day care. Living room/dining area was observed to a parent board by the entrance of the door. A mounted television set was observed in the space. LPA observed all necessary posting available for parents. LPA observed children’s size tables and chairs, children’s cubbies and variety of age appropriate toys. LPA observed a variety of children’s books and children’s blocks. Applicants confirmed that children will eat in the living/dining room area. LPA observed a carbon monoxide and smoke detector in the living/dining room area. A variety of soft toys and manipulatives were observed in the space. LPA observed all electrical outlets covered.

Outside the living room/dinning room area, LPA observed the Kitchen. All kitchen cabinets were observed and inspected. The stove, refrigerator, sink and counter space area were observed and inspected. Knifes and sharp object were observed to be made inaccessible to the children in care. Applicant confirmed that facility will be providing meals and snacks. LPA discuss food preparation, storage and ensuring a log and information regarding dietary restrictions and allergies are kept up to date. As a COVID precautions, LPAs advised applicants to use disposable paper goods. LPA observed the working fire extinguisher mounted by the back door next to the refrigerator.

Outside the kitchen area, a side door that leads to the backyard was observed. Applicant confirmed the door will remain locked during the hours of operations. A closet was observed to have a washer and dryer set and it was observed to have a safety latch, making the closet inaccessible to the children in care. LPA observed the fire pull station outside the bathroom.

The bathroom that children will use was observed outside Bedroom 1. A toilet, sink, cabinets and shower were inspected. All electric outlets were observed to be covered and cabinet under the sink was inspected. LPA discussed COVID-19 recommendation such as using paper towels and displaying a handwashing sign for children to view.
SUPERVISOR'S NAME: Claudia EscobedoTELEPHONE: (424) 301-3044
LICENSING EVALUATOR NAME: Judy LaureanoTELEPHONE: (424) 301-3060
LICENSING EVALUATOR SIGNATURE:

DATE: 04/22/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/22/2022
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
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: GAVALJYAN FAMILY CHILD CARE
FACILITY NUMBER: 197494931
VISIT DATE: 04/22/2022
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Outside the bathroom, LPA observed bedroom 1 which has been designated for the day care as a napping area. LPA observed a small twin size bed and 4 napping cots. The area was observed to have a closet with a applicant’s clothes and additional materials for the daycare.

Outdoor area was observed to have a variety of children’s outdoor toys. LPA observed a plastic slide structure with children’s tricycles. The structure does have soft landing for when children slide down the structure. A grassy shaded area was observed. Applicant confirmed that the outdoor space is not shared with the front house.

The licensing determination of this application will be reviewed with Licensing Program Manager for final resolution.

Exit interview conducted, and report was reviewed with the applicant Anahit Gavaljyan.

SUPERVISOR'S NAME: Claudia EscobedoTELEPHONE: (424) 301-3044
LICENSING EVALUATOR NAME: Judy LaureanoTELEPHONE: (424) 301-3060
LICENSING EVALUATOR SIGNATURE:

DATE: 04/22/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/22/2022
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
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: GAVALJYAN FAMILY CHILD CARE
FACILITY NUMBER: 197494931
VISIT DATE: 04/22/2022
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The following was discussed with the applicant:
Applicant was made aware of The Child Care Advocate Program (CCAP) that is administered from within the Community Care Licensing Division. CCAP participates in many community activities and special projects in order to disseminate information on the State’s licensing role, provide information to the public and parents on childcare licensing, and provide many other helpful resources to the licensees and the public. CCAP’s direct contact information is as followed: Phone number: (916) 654-1541
Email Address: childcareadvocatesprogram@dss.ca.gov
Immunizations: Commencing September 1, 2016, SB 792, prohibits a person from being employed or volunteering at a childcare facility or family day care if he or she has not been immunized against influenza, pertussis and measles. LPA discussed the influenza waiver during the inspection.
Mandated Reporter Training: Beginning on January 1, 2018, AB 1207, requires all licensed providers, applicants, directors and employees to complete training as specified on their mandated reporter duties and to renew their training every two years. Volunteers are encouraged but not required to take the training. Website: www.mandatedreporterca.com. Licensee was reminded of their responsibility to report suspected child abuse.

Licensee was made reminded that it is the licensee’s, as well as anyone who assists in providing care responsibility to know the regulations. Licensee was also encouraged to read the Child Care quarterly updates every season as they come out to stay informed of any changes or updates to statutes and regulations.

Applicant was advised that regulation prohibits the smoking of tobacco in a private residence licensed as a family childcare home during the hours of operation.



Applicant was made aware that state law prohibits baby walkers, bouncy seats, exer-saucers and any other items that fall into that category. Applicant was also reminded that only children who are eating may be in highchairs and that car seats are utilized only for transportation.
SUPERVISOR'S NAME: Claudia EscobedoTELEPHONE: (424) 301-3044
LICENSING EVALUATOR NAME: Judy LaureanoTELEPHONE: (424) 301-3060
LICENSING EVALUATOR SIGNATURE:

DATE: 04/22/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/22/2022
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
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: GAVALJYAN FAMILY CHILD CARE
FACILITY NUMBER: 197494931
VISIT DATE: 04/22/2022
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LPA discussed the safe sleep regulations with applicant [or facility representative] 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.

LPA also informed applicant [facility representative] 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.

This facility plans to provide Incidental Medical Services – IMS. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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: http://www.ada.gov/childqanda.htm

· Applicant was reminded that all adults 18 and over responsible for administration or direct supervision of staff, persons who provides care and supervision to children, and staff who have contact with children, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed.


· In the absence of the licensee a qualified adult must be present supervising the children; a qualified adult is an individual who has a valid and current adult/infant CPR & Pediatric First Aid certification and a valid criminal record clearance associated to the facility license.
· A current roster of children enrolled must be available and maintained for a period of three years, even after children no longer are attending the facility.

· Annual fees must be paid promptly and by the due date or a late fee shall be assessed, and/or the License shall be terminated. (If paying by check please make sure to write facility number on check to ensure that payment is applied to your facility number)

SUPERVISOR'S NAME: Claudia EscobedoTELEPHONE: (424) 301-3044
LICENSING EVALUATOR NAME: Judy LaureanoTELEPHONE: (424) 301-3060
LICENSING EVALUATOR SIGNATURE:

DATE: 04/22/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/22/2022
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
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: GAVALJYAN FAMILY CHILD CARE
FACILITY NUMBER: 197494931
VISIT DATE: 04/22/2022
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· The fire extinguisher type 2A-10BC must be serviced annually or as often as necessary. Smoke and carbon monoxide detectors should be checked, and batteries should be replaced.

· Changes should be reported the to the Department as soon as they occur such as construction and remodeling, telephone number changes and/or if you move from home.

· Reporting requirements: Applicant must report any unusual incident or injuries to the Child Care Regional office by telephone within 24 hours and in writing within 7 days. Applicant was provided with LIC 624 as a reference.

· Fire and safety drills must be performed every six months and documented for review by the Department.

· All adults living and working in the home shall be made of aware of the Departments right to inspection authority, which includes but not limited to the right to enter the home when children are being cared for, interview children and adults and review documentation.

· LPA advised the applicant how to access forms, regulations and quarterly updates on the Child Care Licensing website at: www.ccld.ca.gov

· Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platform. To receive important licensed-related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.



SUPERVISOR'S NAME: Claudia EscobedoTELEPHONE: (424) 301-3044
LICENSING EVALUATOR NAME: Judy LaureanoTELEPHONE: (424) 301-3060
LICENSING EVALUATOR SIGNATURE:

DATE: 04/22/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/22/2022
LIC809 (FAS) - (06/04)
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