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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198013477
Report Date: 07/16/2024
Date Signed: 07/16/2024 03:39:06 PM


Document Has Been Signed on 07/16/2024 03:39 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551



FACILITY NAME:MIRZAYAN FAMILY CHILD CAREFACILITY NUMBER:
198013477
ADMINISTRATOR:MIRZAYAN, HASMIKFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(818) 631-5259
CITY:SUNLANDSTATE: CAZIP CODE:
91040
CAPACITY:14CENSUS: 14DATE:
07/16/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Hasmik Mirzayan, LicenseeTIME COMPLETED:
03:55 PM
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On Tuesday, July 16, 2024, Licensing Program Analyst (LPA) Evelyn Garcia conducted an unannounced annual inspection and met with licensee Hazmik Mirzayan who guided LPA Garcia on a tour of the facility. There were 14 children in care and all were napping and 1 staff member assisting with care and supervision of the children. Operating hours are Monday- Friday, 7:00am- 6:00pm. Residing in the home are licensee and spouse, all adults have been fingerprinted and cleared. This facility is a single-story home that consists of 3 bedrooms, 4 bathrooms, kitchen, living area, dining room, laundry room, pantry, fireplace (barricaded). The garage has been converted to a daycare room that functions as the main day care area where pay, meals and napping take place. There are no pools, spas or bodies of water on premises.

Areas off limits to children include- All bedrooms, 3 bathrooms, kitchen, pantry and front yard, right side of back yard, that is gated and inaccessible to the children. There is a door that prevents the children from accessing bedrooms and off limits bathrooms that remains locked. Pantry door remains locked and inaccessible to the children.

Areas on limits for the children include- living room, daycare area, dining room, bathroom (Located inside daycare room) and backyard fenced.

LPA Garcia inspected the facility for safety, comfort, cleanliness, ventilation and working phone (cell phone). For ventilation, LPA Garcia observed central AC and the vents located on the ceiling. LPA observed the furniture, children’s materials, to be in good condition and age appropriate. LPA observed mats utilized for nap time and napping takes place in daycare room.

LPA Garcia observed cleaning compounds stored inside a kitchen cabinet under the sink, however, was not secured with a safety latch. Licensee stated the kitchen is off limits. LPA suggested either a barricade or safety latch needs to be installed to prevent access to the children to cleaning compounds. Licensee will install safety latch.

SUPERVISOR'S NAME: Mariela RamonTELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Evelyn GarciaTELEPHONE: (661) 202-3785
LICENSING EVALUATOR SIGNATURE:
DATE: 07/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/16/2024
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
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: MIRZAYAN FAMILY CHILD CARE
FACILITY NUMBER: 198013477
VISIT DATE: 07/16/2024
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Knives are stored in a kitchen drawer and licensee will install safety latch . For water drinking, licensee stated filtered water is dispensed and use individually labeled cups and licensee currently participates in a food program.

LPA Garcia entered the bathroom utilized by the children (inside daycare room) and observed the toilet, hand washing sink, hand soap. Cleaning materials were not observed to be stored in the bathroom. LPA observed the restroom to be in operable condition.

LPA Garcia asked the licensee if there were any pets, poisons, firearms, weapons. The licensee stated there is a pet dog that does not come into contact with the children, no poisons, no firearms, and no weapons. LPA did not observe pets, poisons, firearms, or weapons. The license was informed that if any poisons (ex; Drano, rat poison or items that fall into that category), firearms and weapons are purchased, it is required to be locked with a key or combination lock and firearm and ammunition must be stored separately.



LPA Garcia inspected the backyard and observed climbing equipment and poured rubber that may cushion a fall. There are several sunshade sails that provide shade to the outdoor play space. The backyard was observed to be divided into 2 sections, the right section of the backyard is gated with and off-limits to the children. The remainder of the backyard is accessible to the children and fenced. LPA Garcia inspected the play outdoor areas that are utilized by children for safety, comfort, and cleanliness. LPA observed the play equipment to be age appropriate and in a safe condition, free of sharp, no lose or pointed parts. The surface of the outdoor activity space (concrete) is maintained in a safe condition and is free of hazards. For outdoor water drinking, children bring out their individual water bottles and refill as needed.

LPA Garcia observed the required 2A10BC fire extinguisher located in the daycare room with the valve on the green area indicating fully charged with purchase receipt taped to it. LPA advised licensee that the fire extinguisher must be re-purchased or serviced on a yearly basis. LPA observed the dual carbon monoxide detector near the bathroom in the daycare room. There is an additional carbon monoxide detector near the kitchen in the daycare room. The licensee tested the dual carbon monoxide and smoke alarm. LPA Garcia heard the sounds and are operable. LPA observed the first aid complete and was stored in a cabinet in the daycare room. For ill isolation, licensee stated the living room is used for ill isolation until parents pick up the child. The last disaster drill was conducted on 7/16/2024. Facility Roster was observed to be complete.
SUPERVISOR'S NAME: Mariela RamonTELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Evelyn GarciaTELEPHONE: (661) 202-3785
LICENSING EVALUATOR SIGNATURE:

DATE: 07/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/16/2024
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
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: MIRZAYAN FAMILY CHILD CARE
FACILITY NUMBER: 198013477
VISIT DATE: 07/16/2024
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LPA Garcia observed licensee Pediatric First Aid/ CPR certification dated 7/23/22. Health and Safety certification will be taken along with CPR renewal. Child Abuse Mandated Reporter (AB 1207) dated 7/20/22. Proof of immunization against Pertussis, Measles, TB, and Influenza were observed. Licensee was advised that the mandated reporter training must be completed every 2 years and is available at www.mandatedreporterca.com and is set to expire at end of month along with CPR.

LPA observed all of the required postings which include Facility Sketch, Notification of Parent’s Rights, Earthquake Preparedness, Disaster Plan, License.

The following was also discussed with the licensee:


1. In the absence of the licensee a qualified adult must be present, supervising the children; a qualified adult is an individual who has a valid and current Pediatric first aid/ CPR-adult-child- infant certification (EMSA approved), a valid criminal record clearance associated to the facility license, immunization's (MMR, TDAP, TB and Influenza or Influenza declination), AB 1207 Child Abuse Mandated Reporter Certificate.

2. A current roster of children enrolled must be available and maintained for a period of 3 years, even after children are no longer attending the facility.

4. Annual fees must be paid promptly and by the due date or a late fee shall be assessed and/or the license shall be terminated.

5. The fire extinguisher type 2A-10BC must be serviced annually or as often as necessary and smoke and carbon monoxide detectors should be checked, and batteries replaced as needed.

6. Changes should be reported to the Department as soon as they occur such as construction, remodeling, telephone number changes and/or if you move from your home.



7. Any unusual incidents or injuries must be reported to the Department within 24 hours via telephone and within seven (7) days in writing (refer to LIC 624B). Mandated reporter requirements were reviewed and explained.

8. Fire and safety drills must be performed every six (6) months and documented for review by the Department.

SUPERVISOR'S NAME: Mariela RamonTELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Evelyn GarciaTELEPHONE: (661) 202-3785
LICENSING EVALUATOR SIGNATURE:

DATE: 07/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/16/2024
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
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: MIRZAYAN FAMILY CHILD CARE
FACILITY NUMBER: 198013477
VISIT DATE: 07/16/2024
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9. Smoking is prohibited in the family childcare home.

10. Children and staff records must be maintained and updated as needed and be available for review by the Department.

11. Immunization Requirement: H&S 1597.622: 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. The licensee and all adults working with children have proof of immunizations.

12. Inspection Authority: All adults living and working in the home shall be made of aware of the Department’s right to inspection the home, which includes, but is not limited to the right to enter the home when children are being cared for, interview children and adults and review documentation.



13. The facility license number must be on all advertisements, publications, or announcements with the intent to attract clients.

14. Isolation for Ill children: When a child is ill, he/she shall be separated from other children (reference 102417(e) Operation of a Family Child Care Home).

15. Liability Insurance was discussed; LPA advised applicant to review Title 22 Regulation 102417(m)(1) for additional information.

13. Dog(s) and/or pets are recommended to be isolated from children in care.

14. No baby bouncers, no infant walkers, no Johnny jumpers, no saucer chairs, and any other item that falls into this category is not permitted in the facility.



To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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/inspection-process.
SUPERVISOR'S NAME: Mariela RamonTELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Evelyn GarciaTELEPHONE: (661) 202-3785
LICENSING EVALUATOR SIGNATURE:

DATE: 07/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/16/2024
LIC809 (FAS) - (06/04)
Page: 4 of 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: MIRZAYAN FAMILY CHILD CARE
FACILITY NUMBER: 198013477
VISIT DATE: 07/16/2024
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Licensee 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 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 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.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02CCP. 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, Hasmik confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO at Megans Law website.

There are no deficiencies being cited during this inspection.

An exit interview was conducted, and a signed copy of this report was provided to the licensee, Hasmik Mirzayan.

SUPERVISOR'S NAME: Mariela RamonTELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Evelyn GarciaTELEPHONE: (661) 202-3785
LICENSING EVALUATOR SIGNATURE:

DATE: 07/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/16/2024
LIC809 (FAS) - (06/04)
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