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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197750026
Report Date: 09/21/2020
Date Signed: 09/22/2020 11:02:54 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:HAYKAZUNYADZ CHILD CARE CENTER INC.FACILITY NUMBER:
197750026
ADMINISTRATOR:SATENIK, TERGRIGORYANFACILITY TYPE:
850
ADDRESS:7745 WEST APPERSON STREETTELEPHONE:
(818) 522-4172
CITY:TUJUNGASTATE: CAZIP CODE:
91042
CAPACITY:121CENSUS: 52DATE:
09/21/2020
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
02:30 PM
MET WITH:SATENIK, TERGRIGORYAN- DirectorTIME COMPLETED:
06:30 PM
NARRATIVE
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On Monday September 21st, 2020 Licensing Program Analyst (LPA) Nadia Flores conducted a 10-day initial complaint investigation. LPA observed 52 children in care with 7 adults. Upon verifying the staff present in the facility, LPA observed that that one staff #1 was not background cleared. Director and Assistant Director stated that staff has been employed since 2018. Staff #1 was sent home during this time.


Deficiencies cited (LIC 809D)

Exit interview conducted a copy of this report, notice of site inspection and appeal right were discuss and were left with Licensee.
SUPERVISOR'S NAME: Carissa BellTELEPHONE: (661) 202-3359
LICENSING EVALUATOR NAME: Nadia FloresTELEPHONE: (661) 568-8103
LICENSING EVALUATOR SIGNATURE:

DATE: 09/21/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/21/2020
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, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: HAYKAZUNYADZ CHILD CARE CENTER INC.
FACILITY NUMBER: 197750026
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/21/2020
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
09/21/2020
Section Cited

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102370(d)(1) Criminal Record Clearance (d)All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1596.871 shall prior to working, residing, or volunteering in a licensed facility:
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 (1) Obtain a California clearance or a criminal record exemption as required by the Department. This requirement was not met as evidenced by LPA reviewed documents proving that employee was working in the home without fingerprint clearance.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Carissa BellTELEPHONE: (661) 202-3359
LICENSING EVALUATOR NAME: Nadia FloresTELEPHONE: (661) 568-8103
LICENSING EVALUATOR SIGNATURE:
DATE: 09/21/2020
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/21/2020
LIC809 (FAS) - (06/04)
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