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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197700310
Report Date: 06/26/2019
Date Signed: 06/26/2019 11:09:10 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1605 EAST PALMDALE BLV, STE A
PALMDALE, CA 93550
FACILITY NAME:WICKWARE-KIRAJYAN FAMILY CHILD CAREFACILITY NUMBER:
197700310
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 0DATE:
06/26/2019
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
08:35 AM
MET WITH:Liana Wickware-KirajyanTIME COMPLETED:
11:23 AM
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Licensing Program Analyst's (LPAs), Smith and Thompson-Miller, met with Applicant Liana Wickware-Kirajyan to conduct a Pre-Licensing Inspection. Applicant is requesting to provide care and supervision for a Small Family Child Care Home for the capacity of 8 children. Currently residing in the home is Applicant (Criminal Record Clearance (DOJ/FBI and Child Abuse Index Child cleared) and no children. Applicant and LPA's toured the home indoor and outdoor to ensure the home meets licensing requirements. Applicant is requesting the days and hours of operation will be Monday through Friday 6:00 AM to 11:00 PM. Incidental Medical Services (IMS) policy was discussed.

The home is set up as follows: This is a one-story home with 3 bedrooms, 5 bathrooms, living room, formal dining room, enclosed patio, laundry room and no garage. Per Applicant, the following areas of the home with be utilized for Family Child Care: Living/formal dining room, bedroom #1 (nap room) and bathroom #1 in hallway and backyard bathroom #4. The home is gated from the front yard to the backyard. The off-limits of the home are: Bedrooms, #2, #3, bathrooms #2, #3, #5, kitchen and laundry (entrance from outside). The home is neat and clean; there is a working cell phone. There is a fireplace (screened). The home has central heating and air conditioning. There is a gate separating the kitchen from the living/formal dining - child care area. There is an enclosed patio (off limits) adjacent to the kitchen used for child care. There is an attached bedroom and bathroom (off limits) with access only from outside. The garage has been converted to a kitchen, living room space and a bathroom (off limits to children). Applicant stated she will provide meals (breakfast, lunch, snack).

There are no sharp utensils, poisons, medications accessible to children. The kitchen located adjacent to the child care room has a safety gate and will be used entirely for children (food, plates, toys). Bathrooms were toured and inspected, sink/toilet are in operable condition. All unused electrical outlets are plugged and made inaccessible to children. There are age appropriate play equipment and toys available. The children will nap on cots.

The backyard is fenced, the outdoor play area is clean and free from debris. No pets. There is a large jungle gym that is anchored, no body of water (pool, water fountain), two sheds are locked, age appropriate toys, Little Tikes, shaded area, and garden. The front yard has a porch that will also be used to play. Applicant advised to supervise children while at play in the front yard and backyard. Applicant is also advised to consider having a fingerprint cleared and associated assistant to assist with the children and/or when necessary.
SUPERVISOR'S NAME: Carissa BellTELEPHONE: (661) 789-6953
LICENSING EVALUATOR NAME: Suzanne SmithTELEPHONE: (661) 305-3012
LICENSING EVALUATOR SIGNATURE:

DATE: 06/26/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/26/2019
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 4
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1605 EAST PALMDALE BLV, STE A
PALMDALE, CA 93550
FACILITY NAME: WICKWARE-KIRAJYAN FAMILY CHILD CARE
FACILITY NUMBER: 197700310
VISIT DATE: 06/26/2019
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Applicant has current CPR, First Aid Training with the expiration dates of 5/3/2021 and Prevented Health and Safety Training completed 5/3/2019. All adults in the home have a fingerprint clearance and TB exam. Applicant has proof of being immunized against influenza, pertussis and measles.

Applicant was advised of the requirement to report unusual incidents and/or injuries to the parent/guardian and Licensing within the time frame specified by the regulation and on the form LIC624B (call within 24 hours and submit within 7 work days the required form). Pamphlet providing Information regarding SIDS, Safe Sleep, Seat Belt Safety and Notification of Parent's Rights poster (Palmdale Regional Child Care Office) was provided. The "Notification of Parent's Rights" poster must be posted in an area of the home accessible to parents. The information regarding new legislation with regards to exemptions and Parent’s Rights was also discussed.

The following was discussed with the Applicant:
Capacity requirements, Notification of Parent's Rights, Roster requirements (keep updated names and blue sheet), Documentation requirements for disaster drills (fire and earthquake). Mandatory Forms for the children’s files and provider’s files, Safe Sleep and information on shaking baby syndrome. The role and responsibilities of being a mandated reporter were reviewed. Applicant reminded that supervision is required at all times to children in care. Applicant was advised on how to access forms and Regulations for Family Child Care online at www.ccld.ca.gov. Applicant was made aware that it is her responsibility to know the regulations as well as anyone who assists in providing care. Applicant advised that inaccessibility of hazards must be constantly reassessed depending on the children in care. Licensing must have the facility’s phone number at all times; if the phone number is changed, licensing must be notified. Regulation prohibits the smoking of tobacco in a private residence that is licensed as a family child care home and in those areas of the family day care home where children are present (24/7 ban). State law prohibits baby walkers, bouncy seats, exersaucers and any other items that fall into that category.

**Senate Bill AB 633 - Child Care Facilities: Parent Notification Requirements
Summary: This bill amends Health and Safety Code (HSC) sections 1596.859, 1596.8595, 1596.8895, and 1597.05 to improve the transparency of licensing records and to ensure that parents/guardians using a licensed child care facility are aware of situations that present the greatest danger to children.

Each report (documenting a Type A citation) shall remain posted for 30 days along with the Notice of Site Visit (printed out during this inspection). Family child care homes shall post during hours of operation. Failure to meet the posting requirements shall result in an immediate $100.00 civil penalty. For the following 12 months, all parents of currently enrolled children and any newly enrolled children, shall receive a copy of report and sign the LIC 9224 acknowledging receipt. Civil Penalty assessments will be assessed if all above requirements are not adhered to.
SUPERVISOR'S NAME: Carissa BellTELEPHONE: (661) 789-6953
LICENSING EVALUATOR NAME: Suzanne SmithTELEPHONE: (661) 305-3012
LICENSING EVALUATOR SIGNATURE:

DATE: 06/26/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/26/2019
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, 1605 EAST PALMDALE BLV, STE A
PALMDALE, CA 93550
FACILITY NAME: WICKWARE-KIRAJYAN FAMILY CHILD CARE
FACILITY NUMBER: 197700310
VISIT DATE: 06/26/2019
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Applicant states there are no weapons in the home or on the premises.

--Applicant was advised visit www.shotsforschool.org for Immunization information.
--Applicant was informed of responsibility to report suspected Child Abuse, 1-800-827-8724
--Family Child Care Providers (Disaster Planning information): https://ccld.family-child-care-providers/disaster-planning-and-fire-safety/
--Child Care Videos: https://ccld.childcarevideos.org
--Child Care Advocates information: www.childcareadvocatesprogram@cdss.ca.gov
--Applicant was advised to visit the CCL website (www.ccld.ca.gov) to obtain updates of courses and updates/changes to the regulations.

Please be mindful of the following safe sleep best practices:

• Always place infants on their backs for sleeping

• Use only a tight-fitting sheet on the crib or play yard mattress

• Do not hang any items from the crib or above the crib

• Keep all items, including blankets, out of the crib or play yard

• Pacifiers may be used as long as they do not have items attached to them

• Infants should not be swaddled or have any items covering them while sleeping

• The temperature of the room should be comfortable enough for an adult to wear a t-shirt and not be too hot or too cold

Note: the above guidelines are recommendations for best practices only, until regulations are approved and adopted.

Thank you for all that you do to help keep our children safe.

AAP: https://www.healthychildren.org/English/ages-stages/baby/sleep/Pages/A-Parents-Guide-to-Safe-Sleep.aspx

NIH: https://safetosleep.nichd.nih.gov/safesleepbasics/environment/room/text_alternative

Safe to Sleep Campaign: https://safetosleep.nichd.nih.gov/materials

SUPERVISOR'S NAME: Carissa BellTELEPHONE: (661) 789-6953
LICENSING EVALUATOR NAME: Suzanne SmithTELEPHONE: (661) 305-3012
LICENSING EVALUATOR SIGNATURE:

DATE: 06/26/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/26/2019
LIC809 (FAS) - (06/04)
Page: 3 of 4
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1605 EAST PALMDALE BLV, STE A
PALMDALE, CA 93550
FACILITY NAME: WICKWARE-KIRAJYAN FAMILY CHILD CARE
FACILITY NUMBER: 197700310
VISIT DATE: 06/26/2019
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Applicant informed to review Quarterly updates/regulations for 2015-2019 on the department website: Summer 2015 - Incidental Medical Services information.

**Incidental medical Services (IMS) policy was discussed. Applicant will wait until facility opens to determine IMS needs. For IMS information see Evaluator Manual – Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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 http://www.ada.gov/childqanda.htm

Before licensure the following must be completed:
1. Backyard area between the outside bathroom #5 and sheds shall be inaccessible.
2. Backyard area between shed and trash area shall be inaccessible.

Once corrections have been verified, the application for a small Family Child Care Home will be submitted for approval with a maximum capacity of 006 or 008 with parent notification. Applicant advised that all corrections are due within 30 days or the application may be withdrawn.

**Applicant was given the pre-licensing application packet with licensing forms included.
Exit interview conducted: A copy of this report, notice of site inspection was discussed and left with Liana Wickware-Kirajyan, Applicant.
SUPERVISOR'S NAME: Carissa BellTELEPHONE: (661) 789-6953
LICENSING EVALUATOR NAME: Suzanne SmithTELEPHONE: (661) 305-3012
LICENSING EVALUATOR SIGNATURE:

DATE: 06/26/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/26/2019
LIC809 (FAS) - (06/04)
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