<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198017011
Report Date: 04/26/2024
Date Signed: 04/26/2024 02:26:45 PM


Document Has Been Signed on 04/26/2024 02:26 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
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754



FACILITY NAME:ADAMIAN FAMILY CHILD CAREFACILITY NUMBER:
198017011
ADMINISTRATOR:ADAMIAN, VERJIKFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(818) 957-8995
CITY:LA CRESCENTASTATE: CAZIP CODE:
91214
CAPACITY:14CENSUS: DATE:
04/26/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Verjik AdamianTIME COMPLETED:
02:50 PM
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 04/26/2024 , Licensing Program Analyst (LPA) Shushanik Safaryan conducted an unannounced annual random inspection to the above facility. LPA met with Licensee, Verjik Adamian , to whom the reason for the visit was explained. Per Licensee, there are 11 children currently enrolled. There were 6 children and licensees assistant Arpik Gharabeigi and Joseph Adamian licensees husband present upon arrival. The licensee was observed to be operating within the license capacity limitations.

The licensee states that 3 adults and no children currently live in the home. All adults living in the home have obtained a criminal record clearance.

This is a one-story home which consists of 3 bedrooms, 2 and 1/2 bathrooms, kitchen, dining room, living room, den (activity room), garage, and backyard (fenced). The children use some part of living room, bathroom in the living room, den (activity room), and front part of backyard (fenced).
Licensees make off limit areas inaccessible to the children by safety gates. Per licensee, areas off limits to children and parents include: 3 bedrooms, some part of living room, dining room, kitchen, 2 bathrooms, garage, and small yard in the back of the building.
During this visit, all areas identified that are accessible for children to use were inspected for the safety, comfort, and cleanliness. At 12:00 pm Licensee guided LPA to the tour of the home. LPA was toured starting from the living room, where LPA observed child safety gate separating off limit areas(part of the living room , dining room, and kitchen) and making it inaccessible to the children in care . Next LPA observed another child safety gate separating hallway where the off-limit bedrooms and bathrooms located .LPA toured the den where main care provided and observed children toys , TV , chairs . Next LPA toured children’s bathroom and did not observe any hazards. LPA observed complete First Aide Kit located in the bathroom cabinet . Next LPA toured the front part of the backyard where children play during the outdoor play time . In outdoor area LPA observed grass area , play structure . Per licensee , outdoor area temporary will be out of use until some minor fixing complete .
Page 1 of 4
SUPERVISOR'S NAME: Claudia GuangorenaTELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Shushanik SafaryanTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:
DATE: 04/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/26/2024
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 6


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: ADAMIAN FAMILY CHILD CARE
FACILITY NUMBER: 198017011
VISIT DATE: 04/26/2024
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
Facility License, Emergency Disaster Plan, Parent’s Rights Poster, and Earthquake Preparedness Checklist were observed to be behind the main door .A current children’s roster was available for review.

There is telephone service via landline that stays at the facility during operation hours. Hours of operation are Monday – Friday, 7:30 am – 5:30 pm. There is central air and heating in the home.

Detergents, cleaning compounds, and medications were observed to be inaccessible to children. Per Licensee, there are no poisons in the home. LPA advised that any poisons should be locked under key or combination lock. Licensee states that there are no firearms or weapons stored in the home.

The valve on the required 2A 10BC fire extinguisher indicates fully charged and LPA observed service tag with service date 10/26/2023. Smoke and carbon monoxide detectors were tested and are operable.

All homes shall conduct fire and disaster drills at least once every six months and document the date and time of each drill. Last drill documented was conducted on 10/27/2023.

The home is observed to be clean and orderly. There are first aid supplies available. There are age-appropriate toys available for children.

Per licensee, she provides food for children in care. Licensee was advised that if food is brought from the children’s homes, all containers must be labeled with child’s name and properly stored or refrigerated.
Currently, children are using the backyard for outdoor play time. The outdoor play area was observed to be fenced and gated. LPA observed that the outdoor yard has toys and other materials for children to play with. LPA did not observe any objects that can pose danger to children. No bodies of water were observed on this day.
Licensee and staff records were reviewed. The licensee has completed training on preventive health practices including Pediatric First Aid and CPR. The licensee's Pediatric First Aid and CPR expires on 04/27/25.
LPA observed that the Licensee does have proof of Mandated Reporter AB 1207 compliant Child Care Training Certificate on file with expiration on 07/2023 . Licensees first language is Armenian .Per Licensee licensee’s son helps with the translation and will help to complete the Mandated Reporter Training www.mandatedreporterca.com Page 2 of 4
SUPERVISOR'S NAME: Claudia GuangorenaTELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Shushanik SafaryanTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 04/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/26/2024
LIC809 (FAS) - (06/04)
Page: 2 of 6
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: ADAMIAN FAMILY CHILD CARE
FACILITY NUMBER: 198017011
VISIT DATE: 04/26/2024
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
Children’s records were reviewed, including emergency information, and were observed to be complete. Licensee states she is currently caring for 6 infants with the staggered schedule . During the visit LPA observed only 4 infants over 12 months . LPA reminded licensee that 15 minutes checks need to be recorded and filed in children`s file for the Department review . Per Licensee 15 minutes checks are done every day during the nap time , but licensee was not able to find completed paperwork.
LPA created an LIC 857, Children’s Record Review, and LIC 859, Staff Record Review which documents staff and children’s files reviewed during this inspection.
Per licensee, there are no animals on the premises.
Smoking is prohibited in a licensed Family Child Care Home. Per Licensee, no one smokes in the home.
LPA did not observe the following items in the day care area during the inspection: Infant Walkers, Johnny Jumpers, Saucer Chairs, and/or any other item that fall into these categories are not permitted in a family childcare facility.
Per Licensee no IMS needed at this time .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/.
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.

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.

Page 3 of 4

SUPERVISOR'S NAME: Claudia GuangorenaTELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Shushanik SafaryanTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 04/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/26/2024
LIC809 (FAS) - (06/04)
Page: 6 of 6
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: ADAMIAN FAMILY CHILD CARE
FACILITY NUMBER: 198017011
VISIT DATE: 04/26/2024
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
Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain childcare by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California

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

Currently, the licensee is in compliance with California Code of Regulations Title 22. No deficiencies cited.

Exit interview conducted and report was reviewed with the licensee


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

Failure to comply with posting requirements shall result in an immediate civil penalty of $100.



Page 4 of 4
SUPERVISOR'S NAME: Claudia GuangorenaTELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Shushanik SafaryanTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 04/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/26/2024
LIC809 (FAS) - (06/04)
Page: 5 of 6