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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198011347
Report Date: 09/24/2019
Date Signed: 10/10/2019 12:46:57 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:VARDANYAN FAMILY CHILD CAREFACILITY NUMBER:
198011347
ADMINISTRATOR:VARDANYAN, HASMIKFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(323) 493-5555
CITY:LOS ANGELESSTATE: CAZIP CODE:
90038
CAPACITY:14CENSUS: 0DATE:
09/24/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Hasmik Vardabyan TIME COMPLETED:
01:01 PM
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Licensing Program Analyst (LPA) Justin Dorsey met with licensee, Hasmik Vardanyan, who guided analyst on a tour of the home for an Annual inspection. Upon arrival LPA observed there were no children being cared for by Licensee. Per Licensee there are 3 children enrolled at this time. On 10/10/19 analyst and licensee toured the home. All on limit rooms per facility sketch were inspected. This is a one story home which consists of 1 bedroom, 1 bathroom, kitchen, dining room, living room and back yard. The children use the bathroom, bedroom, living room, and dining room. Per licensee, the kitchen is off limits, there is a kiddie gate to block the entrance, The LPA toured all areas used by children during this visit.

Main care is provided in the family room (first room when entering the home). LPA observed gates separating the main care area from the rest of the house. Children use the bathroom located in the hallway. LPA inspected bathroom for safety. All detergents and cleaning compounds are inaccessible to children. The only off limit area in the home is the kitchen. Per Licensee the children don't use the backyard instead children are taken to a near by park for outdoor activities. The home was inspected inside and out for safety, comfort, cleanliness, telephone service, heating and ventilation, inaccessibility to poisons, detergents/cleaning compounds, and hazardous items that can pose a danger to children. Facility roster complete and maintained current. Fire/earthquake drills current, last conducted in August. Per Licensee children nap in main care area. LPA observed pack and play for napping and 15 cots in bedroom #1 for napping. LPA observed perimeter fencing, and backyard is free of miscellaneous debris/hazards. All trees, shrubs and plants are maintained.

Per licensee, there are no weapons or firearms of any kind in the facility at this time. The LPA did not observe any weapons. The required fire extinguisher (2A10BC) and smoke detectors are in operable condition. The home has a working Carbon Monoxide detector. LPA observed a portable AC unit in the main care area, per licensee the home uses a portable heater when it gets cold. CPR/First Aid expires 12/2019. First aid kit was observed. Licensee has posted as required the License, Emergency Disaster plan and Parents Rights Poster.
SUPERVISOR'S NAME: Adriana HernandezTELEPHONE: (323) 981-3362
LICENSING EVALUATOR NAME: Justin DorseyTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 09/25/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/25/2019
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, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: VARDANYAN FAMILY CHILD CARE
FACILITY NUMBER: 198011347
VISIT DATE: 09/24/2019
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Per Licensee there are no infants enrolled at the home. Licensee was given PIN 19-02-CCP regarding Safe Sleep Awareness Campaign. Initials here confirms PIN 19-02-CCP was received by Licensee. Initials: ____________

The facility was found in compliance per Title 22 regulations, no Type A or B deficiencies will be cited today 10/10/2019. An exit interview was conducted with Licensee Hasmik Vardanyan, The Notice of Site Visit and Appeal Rights were given.
SUPERVISOR'S NAME: Ana ChicoTELEPHONE: (323) 981-3351
LICENSING EVALUATOR NAME: Justin DorseyTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 10/10/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/10/2019
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, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: VARDANYAN FAMILY CHILD CARE
FACILITY NUMBER: 198011347
VISIT DATE: 09/24/2019
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The following was discussed with the licensee: Mandatory Forms for the children’s files and provider’s files, Requirements for fire drills, earthquake drills and documentation for both. Role and responsibilities of being a mandated reporter were discussed. The licensee was advised how to access forms and Regulations for Family) Child Care online at www.ccld.ca.gov . Licensee was made aware that it is their responsibility to know the regulations as well as anyone who assists in providing care. The licensee was 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 licensed as a family child care home 7 days a week, 24 hours a day.

State law prohibits baby walkers, bouncy seats, exer-saucers and any other items that fall into that category. LPA informed licensee each infant shall be constantly supervised and under direct visual observation at all times. LPA explained visual supervision, SIDS and other sleep-related causes of infant death.

Requirements for fingerprint clearances and associations were discussed with the licensee. Licensee can be cited a civil penalty of $100 per day, up to $500.00 for the 1st offense and up to $3000.00 for the 2nd offense within a 12 month period. The licensee 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. The "Notification of Parent's Rights" (2016) 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 licensee was advised that the Notice of Site Visit must be posted at the entrance of the facility for a period of 30 days. If a serious violation is cited, a copy of the licensing report (LIC809 or LIC9099) must also be posted for 30 days. If these requirements are not met, civil penalties in the amount of $100 per violation will be assessed. Copies of the reports must also be provided to each parent when a serious deficiency, Type A, is cited (LIC9224).

SUPERVISOR'S NAME: Ana ChicoTELEPHONE: (323) 981-3351
LICENSING EVALUATOR NAME: Justin DorseyTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 10/10/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/10/2019
LIC809 (FAS) - (06/04)
Page: 2 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, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: VARDANYAN FAMILY CHILD CARE
FACILITY NUMBER: 198011347
VISIT DATE: 09/24/2019
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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. The ADA requires that child care providers not discriminate against persons with disabilities on the basis of disability, that is, that they provide children and parents with disabilities with an equal opportunity to participate in the child care center's programs and services.

The licensee was informed 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 child care 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


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 publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

AB 1207: Beginning on January 1, 2018, this law 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: http://www.mandatedreporterca.com/www.mandatedreporterca.com



Senate Bill 792: this bill, commencing September 1, 2016, prohibits a person from being employed or volunteering at a child care 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 visit.
SUPERVISOR'S NAME: Ana ChicoTELEPHONE: (323) 981-3351
LICENSING EVALUATOR NAME: Justin DorseyTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 10/10/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/10/2019
LIC809 (FAS) - (06/04)
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