198011347-12-15-2023-33-CC-SPEY-CYJPXX-20231215104305

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198011347
Report Date: 12/15/2023
Date Signed: 12/15/2023 10:43:21 AM

Document Has Been Signed on 12/15/2023 10:43 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
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME:	VARDANYAN FAMILY CHILD CARE		FACILITY NUMBER:	198011347
ADMINISTRATOR:	VARDANYAN, HASMIK		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(323) 493-5555
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90038
CAPACITY:	14	CENSUS: 0	DATE:	12/15/2023
TYPE OF VISIT:	Required - 3 Year	UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Hasmik Vardanyan, Licensee		TIME COMPLETED:	11:00 AM

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Licensing Program Analysts LPAs Staicy Perry and Carolyn Tuba conducted an unannounced 3-Yr random inspection to the above facility. At 9:00am LPAs met with licensee Hasmik Vardanyan. The licensee states that she has 3 children currently enrolled. A current children’s roster is available and is current. Licensee’s hours of operation are 8:00-5:00pm, Monday-Friday. A COVID-19 risk assessment was conduct and their has been no cases.

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 #1, living room, and dining room. Per licensee, the kitchen is off limits, there is a kiddie gate to block the entrance, The LPAs toured all areas used by children during this visit. All areas identified on the facility sketch were inspected. The licensee provides food for children in care.

The licensee states that 1 adult and 0 minors currently live in the home. Persons living in the home are identified on the attached LIC811. All individuals present in the home have obtained a criminal record clearance or exemption prior to working, residing, or volunteering in a licensed home. Per licensee, there are no weapons, firearms or bodies of water on the premises.

LPAs were led on a tour of the facility by the licensee Hasmik. Upon entry into the home, LPAs reviewed the living room which is the primary area for childcare. Main care is provided in the family room (first room when entering the home). LPAs observed gates separating the main care area from the rest of the house. Children use the bathroom located in the hallway. LPAs 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.

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SUPERVISOR'S NAME: Claudia Guangorena	TELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Staicy Perry	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 12/15/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/15/2023

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
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: VARDANYAN FAMILY CHILD CARE	FACILITY NUMBER: 198011347
	VISIT DATE: 12/15/2023

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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 rosters complete and maintained current. Fire/earthquake drills current, last conducted on 9/19/2023. Per Licensee children nap in main care area. LPAs observed pack and play for napping and 15 cots in bedroom #1 for napping. LPAs observed perimeter fencing, and backyard is free of miscellaneous debris/hazards. All trees, shrubs and plants are maintained.

LPAs observed age-appropriate toys and equipment present. Emergency Disaster Plan, Parent’s Rights Poster and the Facility License are observed to be posted. The tour continued to the kitchen. Sharp knives are made inaccessible. A fire extinguisher was observed. The valve on the required 2A 10BC fire extinguisher indicates fully charged however, licensee had no receipt of purchase attached. Per State Fire Marshall standards, fire extinguishers shall be serviced annually. LPAs discussed the importance of ensuring the fire extinguisher is serviced or a new canister is purchased annually. Per Licensee she will purchasing a new fire extinguisher on 12/15/2023 and submitting receipt to LPA, Perry by Monday, 12/18/2023.

The licensee states that there are no poisons in the home and understands that storage areas for poisons must be locked with a key or combination lock. There are first aid supplies available. Smoke and carbon monoxide detectors were tested and are operable. Licensee uses cell phone that is kept here all times. Per licensee, living room couch will be used as an area for an ill child until an authorized representative comes to pick up child.

The licensee and other personnel have completed training on preventive health practices including Pediatric First Aid and CPR. The licensee's Pediatric First Aid and CPR expires on 01/2024. Licensee has completed mandated reporter training that expires in 2/3/2024. The licensee does have proof of immunization against influenza, tuberculosis, pertussis, and measles. Children’s records were reviewed, including but not limited to, a copy of the emergency information card that contains all the information specified by regulation.

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SUPERVISOR'S NAME: Claudia Guangorena	TELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Staicy Perry	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 12/15/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/15/2023

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
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: VARDANYAN FAMILY CHILD CARE	FACILITY NUMBER: 198011347
	VISIT DATE: 12/15/2023

NARRATIVE

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-There are no pets on the premises.
-Infant Walkers, Johnny Jumpers, Saucer Chairs, and/or any other item that falls into these categories are not permitted in a family child care facility.
-Smoking is prohibited in a license family child care home.

Licensee [or facility representative] was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated

LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep as an additional resource. LPA also informed licensee [or 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. REPORT CONTINUES PAGE 2 of 3

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02- CCP. 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: https://www.ada.gov/resources/child-care-centers/.

Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

During the exit interview, the Licensee, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

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SUPERVISOR'S NAME: Claudia Guangorena	TELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Staicy Perry	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 12/15/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/15/2023

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
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: VARDANYAN FAMILY CHILD CARE	FACILITY NUMBER: 198011347
	VISIT DATE: 12/15/2023

NARRATIVE

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To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process

Based on the LPA’s observations and records review, the following deficiencies listed on the attached LIC 809 (deficiency page) are being cited in accordance with California Code of Regulations Title 22. Deficiencies that are being cited need to be cleared to protect the children’s health & safety

A notice of site visit was given to licensee Hasmik and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the licensee Rosa Ceja, at 2:55pm. Plan of corrections was developed and reviewed. Copy of report provided.

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SUPERVISOR'S NAME: Claudia Guangorena	TELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Staicy Perry	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 12/15/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/15/2023

LIC809 (FAS) - (06/04)

Page: 4 of 5

Document Has Been Signed on 12/15/2023 10:43 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: VARDANYAN FAMILY CHILD CARE	FACILITY NUMBER: 198011347
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 12/15/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1597.622(c)

Administration of Child Day Care Licensing

(c) The family day care home shall maintain documentation of the required immunizations or exemptions from immunization, as set forth in this section, in the person's personnel record that is maintained by the family day care home. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation the licensee did not comply with the section cited above, Licensee could not provide immunizations records during the inspection, which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 01/02/2024
	Plan of Correction
1 2 3 4	Licensee will provide LPA with immunization record by POC date of 1.2.24

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

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: Claudia Guangorena	TELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Staicy Perry	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 12/15/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/15/2023

LIC809 (FAS) - (06/04)

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