197700534-11-22-2021-12-CC-CHEH-C8ZQ2Q-20211122104730

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197700534
Report Date: 11/22/2021
Date Signed: 11/22/2021 10:47:47 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME:	PIRIJANYAN FAMILY CHILD CARE		FACILITY NUMBER:	197700534
ADMINISTRATOR:	ARMAN PIRIJANYAN		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(818) 314-7802
CITY:	SUNLAND	STATE: CA	ZIP CODE:	91040
CAPACITY:	14	CENSUS: 0	DATE:	11/22/2021
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	08:50 AM
MET WITH:	Arman Pirijanyan		TIME COMPLETED:	11:00 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	On 11/22/2021, Licensing Program Analysts (LPA) Carol Heath, conduct a Pre-Licensing Capacity Increases inspection with Applicant, Arman Pirijanyan to ensure the facility meets basic licensing requirements set forth by Title 22, Health and Safety and statutory requirements. The applicant is requesting to provide care for a Large family childcare home for the capacity of 12 children (age 2-3 years old). The applicant was an employee from the year 2018 as a teacher at Haykazunyadz preschool. Currently, there is 1 adult (applicant) living in the home. LPA toured the home indoor and out to ensure it meets FCCH requirements. The applicant is requesting the days and hours of operation will be Monday through Friday 6:00 AM - 7:00 PM. The home is described as follows: The home consists of Family Room (play area), office, 1 bathroom, kitchen, living room, laundry area, garage, and backyard. The off-limits areas: office and kitchen, Laundry, garage, and Kitchen. Indoor: · Main area Family Room (Play Area): The home does not have central heating and air conditioning. All windows are free of cracks, bugs, and debris. Age-appropriate toys and furniture were observed to be on the premises of this facility. All toys and furniture were observed to be in good condition during this inspection. Bathroom: Children will use bathroom located to the right of the Kitchen. Bathroom was toured and inspected sink/toilet is in operable condition. Bathroom is clean, safe, and operable; the bathtub and shower area are free of hazards. No medications storage in the medicine cabinet. Outside: The backyard was inspected; the backyard is clean and free from all debris. The backyard is surrounded by a brick fence. LPA observed a few toys for children's playtime.

SUPERVISOR'S NAME: Claretta Yates	TELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Carol Heath	TELEPHONE: (661) 202-3709
LICENSING EVALUATOR SIGNATURE:	DATE: 11/22/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/22/2021

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 7

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: PIRIJANYAN FAMILY CHILD CARE	FACILITY NUMBER: 197700534
	VISIT DATE: 11/22/2021

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
26
27
28
29
30
31
32

· Off-limit area: The door will be locked during the operation hours.
Office: This area is only for the applicant and staff.
Kitchen: All sharp utensils and cutlery, cleaning supplies, medicines; drawers and cabinets with
plastic bags, and sharp things or small things children can swallow; are made inaccessible to
children with child safety latches on the sink cabinet. The refrigerator dishwasher, stove, microwave, etc., are clean. The kitchen was clean, orderly, and free of hazardous items.
Laundry room: clean supplies and poison are made inaccessible to children.
Living/Bedroom: The area is only for the applicant. It is his bedroom also. LPA observed few personal items. LPA took a picture of the applicant’s ID. The address is different than his ID. The applicant filled out LIC 855 (Declaration).

Ø Others:
AC/Heating Unit: The house does not have central AC/Heating Unit.
Napping: Children will nap in the designated nap areas with adult supervision. LPA observed 12 Cots.
The First Aid kit is located in the Play area, hanging on the wall inaccessible to children on top of the refrigerator. The First Aid Kit was observed complete with supplies and a first aid manual.
Fire extinguisher (2A10BC): LPA observed there is a required fire extinguisher (2A10BC) fully charged Date: 11/1/2021 and located in the Play area inaccessible to children. It was fully charged in the green.
Smoke Detectors and Carbon Monoxide: The smoke detectors and carbon monoxide devices were tested and in operable condition.
Electrical outlets: All unused electrical outlets are plugged in and made inaccessible to children.
Bodies of water: There is no bodies of water pool on the premises.
Medications and cleaning solutions are stored in the laundry and office cabinet which is made inaccessible to children.
Weapons or Firearms: Per the applicant, there are no weapons or firearms. LPA did not observe any weapons or firearms.
Meals: According to the applicant he is working currently participating in a Nutrition Food Program. The daycare home provides breakfast, morning snacks, lunch, and an afternoon snack.
Transportation: The applicant will not transport daycare children.

SUPERVISOR'S NAME: Claretta Yates	TELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Carol Heath	TELEPHONE: (661) 202-3709
LICENSING EVALUATOR SIGNATURE:	DATE: 11/22/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/22/2021

LIC809 (FAS) - (06/04)

Page: 2 of 7

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: PIRIJANYAN FAMILY CHILD CARE	FACILITY NUMBER: 197700534
	VISIT DATE: 11/22/2021

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
26
27
28
29
30
31
32

Incidental Medical Services (IMS): Incidental Medical Services (IMS) policy was discussed. 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 the publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm. The Applicant will not be providing medication to children.

Ø Documentation:

· CPR/First Aid: LPA observed applicant has current Pediatric CPR and First Aid Training with an expiration date (09/2023) 1 hour of nutrition training, (8) hours of Preventive Health and Safety Training.
· Immunization: The applicant has the required immunizations.
· Mandated Reporter Training: The applicant has completed the online mandated reporter training at www.mandatedreporterca.com, and will renew on 09/24/2023
· Transportation: The applicant does not provide transportation for children.
· Child files: LPA shared all required documentation for children’s file
· Staff File (For Large FCC Only): LPA shared with applicant to transfer his assistant’s fingerprint.
· Fire Drill and Disaster Drill: LPA shared with the applicant the fire and disaster drills are conducted every 6 months.

· Facility Roster: LPA shares LIC9040 Child Care Facility Roster with the applicant

· The applicant will need to post as required:

o The Facility Applicant,

o Emergency Disaster Plan (LIC 610 A)

o Parents Rights Poster (PUB394)

o Earthquake Preparedness (LIC 9148)

SUPERVISOR'S NAME: Claretta Yates	TELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Carol Heath	TELEPHONE: (661) 202-3709
LICENSING EVALUATOR SIGNATURE:	DATE: 11/22/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/22/2021

LIC809 (FAS) - (06/04)

Page: 3 of 7

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: PIRIJANYAN FAMILY CHILD CARE	FACILITY NUMBER: 197700534
	VISIT DATE: 11/22/2021

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
26
27
28
29
30
31
32

The following information was discussed with the applicante:
ü Mandatory Forms for the children’s files and provider’s files (See LIC311D)
ü Requirements for fire drills, earthquake drills, and documentation for both.
ü The role and responsibilities of being a mandated reporter were discussed.
ü Applicant reminded that 100% supervision is required at all times to children in care. The applicant was advised how to access forms and Regulations for Family Child Care online at www.ccld.ca.gov. The applicant was made aware that it is he/she responsibility to know the regulations as well as anyone who assists in providing care. Licensing must have the facility’s phone number at all times; if the phone number is changed, licensing must be notified
ü Capacity requirements, Roster requirements, Posting requirements, Documentation requirements for disaster drills (fire and earthquake). Mandatory Forms for the children’s files and provider’s files, and Safe Sleep Awareness. The role and responsibilities of being a mandated reporter were reviewed. The applicant was reminded that supervision is always required for children in care.

ü Regulation prohibits the smoking of tobacco in a private residence that is applicant. as a family childcare 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.

ü ·On January 1, 2018, or before March 30, 2018, a person who is an applicant childcare provider, administrator, or employee of an applicant child daycare facility shall complete the online mandated reporter training and shall complete renewal mandated reporter training every two years. @www.mandatereporterca.com
ü **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 an applicant childcare facility are aware of situations that present the greatest danger to children.
ü 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 childcare homes shall post during hours of operation. Failure to meet the posting requirements shall result in an immediate $100.00 civil penalty In addition; all parents of currently enrolled children and any newly enrolled child for the following 12 months shall receive a copy of the report and sign the LIC 9224 acknowledging receipt. Civil Penalty assessments will be assessed if all the above requirements are not adhered

SUPERVISOR'S NAME: Claretta Yates	TELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Carol Heath	TELEPHONE: (661) 202-3709
LICENSING EVALUATOR SIGNATURE:	DATE: 11/22/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/22/2021

LIC809 (FAS) - (06/04)

Page: 4 of 7

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: PIRIJANYAN FAMILY CHILD CARE	FACILITY NUMBER: 197700534
	VISIT DATE: 11/22/2021

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
26
27
28
29
30
31
32

ü §1597.622 Employees or volunteers at a family day care home; immunization requirements; records; exemptions (1) Commencing September 1, 2016, a person shall not be employed or volunteer at a family day care home if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year
ü **Incidental Medical Services (IMS) policy was discussed. The applicant will wait until the 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 the publication: Commonly Asked Questions about Child Care Centers and the ADA, available at http://www.ada.gov/childqanda.htm
ü The applicant was made aware that it is their responsibility to know the regulations as well as anyone who assists in providing care. The applicant was advised that the inaccessibility of hazards must be constantly reassessed depending on the children in care. Licensing must always have the facility’s phone number; if the phone number is changed, licensing must be notified.

ü The 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

ü The applicant was informed of the responsibility to report suspected Child Abuse by calling the Child Abuse Hot-line at 1-800-540-4000. Also, call the CCL office and follow up with a written Unusual Incident/Injury Report (LIC 624B).

ü Criminal Record Statement: Applicant [or facility representative] was reminded that all adults 18 and over living or working in the home, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to an initial presence in an applicant Family Child Care Home. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

SUPERVISOR'S NAME: Claretta Yates	TELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Carol Heath	TELEPHONE: (661) 202-3709
LICENSING EVALUATOR SIGNATURE:	DATE: 11/22/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/22/2021

LIC809 (FAS) - (06/04)

Page: 5 of 7

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: PIRIJANYAN FAMILY CHILD CARE	FACILITY NUMBER: 197700534
	VISIT DATE: 11/22/2021

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
26
27
28
29
30
31
32

ü Safe Sleep: LPA discussed the safe sleep regulations with the 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 the applicante [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.

ü Notice of Site Visit: A notice of site visit was given and must remain posted for 30 days.

ü The regulation prohibits the smoking of tobacco in a private residence that is applicantd as a family childcare 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.

ü --Applicant was advised to visit the CCL website (www.ccld.ca.gov) to obtain updates of courses and updates/changes to the regulations.

n Our Quarterly updates come out every 3 months they are also now in Spanish please log in to the CCLD website or you can email our advocates to have the quarterly updates sent directly to your email. Child Care Advocates information: www.childcareadvocatesprogram@cdss.ca.gov

ü The Duty Worker is available for questions Monday through Friday at (661) 202-3318 from 8:00 AM - 5:00 PM.

ü A copy of the Safe Sleep Proposed Regulations was provided to Applicant.

ü Regulation prohibits the smoking of tobacco in a private residence that is applicant as a family childcare 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.

ü Lead Poisoning: For more information, go to the California Childhood Lead Poisoning Prevention Branch’s website at www.cdph.ca.gov/programs/clppb,or call them at (510) 620-5600.

ü Applicant advised visiting www.shotsforschool.org for Immunization information.

SUPERVISOR'S NAME: Claretta Yates	TELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Carol Heath	TELEPHONE: (661) 202-3709
LICENSING EVALUATOR SIGNATURE:	DATE: 11/22/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/22/2021

LIC809 (FAS) - (06/04)

Page: 6 of 7

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: PIRIJANYAN FAMILY CHILD CARE	FACILITY NUMBER: 197700534
	VISIT DATE: 11/22/2021

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
26
27
28
29
30
31
32

ü Child Care Advocates: You can now sign up for Quarterly Updates and PINs for one or more programs through our DSS website at www.ccld.ca.gov. Click on “Receive Important Updates” located in the right middle part of the page, immediately above the Quick links. Put your email address and choose which program(s) you would like to subscribe to and click “subscribe”.

********** Prior to being licensed the following is required: Due 11/29/2021 ***********

 In the backyard, the water heater needs to make it inaccessible to children.

**As a result of this inspection, the home does not meet Title 22 Regulations. Corrections are required.

Exit interview conducted and report was reviewed with the applicant Arman Pirijanyan.

SUPERVISOR'S NAME: Claretta Yates	TELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Carol Heath	TELEPHONE: (661) 202-3709
LICENSING EVALUATOR SIGNATURE:	DATE: 11/22/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/22/2021

LIC809 (FAS) - (06/04)

Page: 7 of 7