198017819-9-5-2023-33-CC-AEIN-CVDP4N-20230905105924

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198017819
Report Date: 09/05/2023
Date Signed: 09/05/2023 10:59:34 AM

Document Has Been Signed on 09/05/2023 10:59 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
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME:	ZOGRABYAN FAMILY CHILD CARE		FACILITY NUMBER:	198017819
ADMINISTRATOR:	ZOGRABYAN, MARIAM		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(818) 547-6013
CITY:	GLENDALE	STATE: CA	ZIP CODE:	91203
CAPACITY:	14	CENSUS: 4	DATE:	09/05/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	08:40 AM
MET WITH:	Mariam Zograbyan, Licensee		TIME COMPLETED:	11:20 AM

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	REQUIRED- 1 YEAR INSPECTION CONDUCTED IN ARMENIAN Licensing Program Analyst (LPA) Anomeh Eivazian conducted an unannounced required 1- year inspection to the above facility on 09/05/23. LPA arrived at the facility at 8:40 AM and met with Mariam Zograbyan, Licensee who guided analyst on a tour of the facility. A COVID 19 risk assessment was conducted prior to entering the facility. Also present during this inspection, was Voskan Galstian, Licensee’s Assistant/husband. Per licensee, facility hours are Monday to Friday from 7:30 a.m. to 6:00 p.m. LPA provided a copy of Entrance Checklist—Family Child Care Home (LIC126) to licensee. This is a one story home located on the first level. The home consists of two units, 343 & 345. The licensee is owner of both 343 & 345. Two units are connected to each other from inside. The home consists of 3 bedrooms, 3 bathrooms, 2 kitchens, dining room, living room, day care room, front yard, backyard (fenced), storage, and converted garage. Per licensee, parents enter the facility through the side way which directly leads to unit 345, daycare area. The Children utilize 345 unit for child care which consists of 1 bedroom, 1 day care room, 1 bathroom, and backyard (fenced). Per licensee, areas off limits to children and parents include: 343 unit which consists of 2 bedrooms, 2 bathrooms, 1 kitchen, living room, dining room, 1 kitchen in 345 unit, storage, converted garage in the backyard, front yard, and back of backyard. There is a door in the day care room which opens to 343 unit and licensee's son's bedroom. During this inspection individuals who reside in the home were discussed and notes on Confidential Name List (LIC811) and attached to this report. All areas identified on the facility sketch that are accessible for children to use were inspected for safety, comfort, and cleanliness. At 9:00 a.m., Licensee took this LPA on a tour of the home. LPA was toured through the interior starting with unit 345, 1 bedroom and 1 daycare room (daycare classrooms), LPA observed children toys, tables, chairs and tables in the daycare area. There is a screen door with (2) locks on the front entrance. In addition, the wrought iron railings and openings leading to front door are covered REPORT CONTINUES ON NEXT PAGE 1 of 5

SUPERVISOR'S NAME: Christina Gabelman	TELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Anomeh Eivazian	TELEPHONE: (323) 981-3391
LICENSING EVALUATOR SIGNATURE:	DATE: 09/05/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/05/2023

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
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: ZOGRABYAN FAMILY CHILD CARE	FACILITY NUMBER: 198017819
	VISIT DATE: 09/05/2023

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with mesh. Next LPA toured the daycare bathroom and did not observe any hazards. There is an open wall heather in the day care room that was screened to prevent access. Also, LPA observed a safety gate was installed to the kitchen to prevent access to the kitchen. LPA observed all electrical outlets were covered in daycare area. During this inspection LPA observed off-limit bedroom door which leads to the 343 was closed. LPA observed the required 2A 10BC fire extinguisher was anchored to the wall by the kitchen in daycare area. It was purchased on 04/23/23 as read by LPA from the receipt. Licensee tested the carbon monoxide detector in the kitchen and smoke detector in the daycare room. Both sounded off the alarms and heard by LPA to be functional. Detergents, cleaning compounds, medications, and other items which could pose a danger to children were observed to be inaccessible to children. 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.

Next LPA toured the backyard fenced. Currently, children are using the some part of back yard for outdoor play time. The children go to the backyard through the daycare room. The outdoor play area was observed to be fenced. 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 a danger to children on the outdoor yard. LPA observed off-limit areas in the backyard are fenced and inaccessible to the children. The licensee states that supervision is always provided.

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. Per Licensee, Mariam Zograbyan at 9:50 a.m there are no pets, weapons, firearms, pools, spas, hot tubs, fish ponds, or similar bodies of water on the premises.

The licensee was observed to be operating within the licensed capacity and is not exceeding the required limitations during this inspection. During this inspection LPA observed four children were playing in the daycare room with licensee and her husband. All adults present have obtained a criminal record clearance on Licensing Information System (LIS). Per licensee, currently she has one assistant. Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, 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 up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

REPORT CONTINUES ON NEXT PAGE 2 of 5

SUPERVISOR'S NAME: Christina Gabelman	TELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Anomeh Eivazian	TELEPHONE: (323) 981-3391
LICENSING EVALUATOR SIGNATURE:	DATE: 09/05/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/05/2023

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
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: ZOGRABYAN FAMILY CHILD CARE	FACILITY NUMBER: 198017819
	VISIT DATE: 09/05/2023

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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 04/2024. Licensee, Mariam Zograbyan did have required mandated reporter training on file during this inspection. There are first aid supplies available on the premises in unit 345 kitchen. LPA advised licensee that if a child shows signs of illness he/she/they shall be separated from other children.

At 10:00 a.m., facility roster was reviewed and completed. Per licensee currently there are 8 children enrolled. LPA reviewed 5 children's records, including emergency information from 8 enrolled children, and all 5 reviewed files were completed.

The licensee and her husband have proof of immunization against influenza, pertussis, and measles. 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 08/28/23.

Emergency Disaster Plan, Parent’s Rights Poster and the Facility License were observed to be posted at the wall by the entrance. LPA did not observe the following items during the inspection: Infant Walkers, Johnny Jumpers, Saucer Chairs, Trampolines and/or any other item that fall into these categories are not permitted in a family child care facility.

Smoking is prohibited in a licensed Family Child Care Home. Per Licensee, no one smokes in the home. There is telephone service via a landline that is used and the cellphone stays at the facility during operation hours. Per licensee she does not carry liability insurance or a bond in accordance with standard established by Family Child Care statue. Signed statements (LIC282) on 5 reviewed files.

INFANT CARE: Licensee states that she provides care to infants 12 months old and up. Per licensee, currently she has one 22 months old infant. Licensee states infants sleep in the daycare bedroom where they are constantly supervised.LPA advised the Licensee that infants shall be placed on their backs for sleeping and shall be supervised. Infants shall be checked on every 15 minutes and the time of each 15-minute check shall be documented with child’s name and date. The LIC 9227 Individual Infant Sleeping Plan shall be completed for each infant up to 12 months of age. A copy of the LIC 9227 was provided to Licensee. LPA provided the licensee with a copy of A Child Care Provider’s Guide to Safe Sleep, by American Academy of Pediatrics. LPA also consulted and explained Child Abuse Reporting, Never Shake a Baby, and Safe Sleeping practices.

REPORT CONTINUES ON NEXT PAGE 3 of 5

SUPERVISOR'S NAME: Christina Gabelman	TELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Anomeh Eivazian	TELEPHONE: (323) 981-3391
LICENSING EVALUATOR SIGNATURE:	DATE: 09/05/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/05/2023

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
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: ZOGRABYAN FAMILY CHILD CARE	FACILITY NUMBER: 198017819
	VISIT DATE: 09/05/2023

NARRATIVE

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SAFE SLEEP: LPA discussed the safe sleep regulations with licensee, and discussed the Child Care Licensing Safe Sleep webpage at http://www.cdss.ca.gov/inforescources/child-care-licensing/public-information-and-resoucrces/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 http://www/cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment. Boppy recall: https://www.cpsc.gov/Recalls/2021/The-Boppy-Company-Recalls-Over-3-Million-Original-Newborn-Loungers-Boppy-Preferred-Newborn-Loungers-and-Pottery-Barn-Kids-Boppy-Newborn-Loungers-After-8-Infant-Deaths-Suffocation-Risk

Medication: Incidental Medical Services (IMS) policy was discussed. The licensee states that she will provide IMS. Per licensee, there are no children enrolled that require IMS at this time. 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.

LPA advised the licensee to access forms, regulations and quarterly updates online at: www.ccld.ca.gov.

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.

The Notice of Site Visit (LIC 9213) was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

REPORT CONTINUES ON NEXT PAGE 4 of 5

SUPERVISOR'S NAME: Christina Gabelman	TELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Anomeh Eivazian	TELEPHONE: (323) 981-3391
LICENSING EVALUATOR SIGNATURE:	DATE: 09/05/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/05/2023

LIC809 (FAS) - (06/04)

Page: 3 of 6

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: ZOGRABYAN FAMILY CHILD CARE	FACILITY NUMBER: 198017819
	VISIT DATE: 09/05/2023

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 experienced. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding inspection tools and methods, please visit the Program website at www.cdss.gov/inforesouces/community-care-liceinsing/inspection-process

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

Exit interview conducted and report was reviewed with the Licensee, Mariam Zograbyan at 11:20 a.m..

REPORT END 5 of 5

SUPERVISOR'S NAME: Christina Gabelman	TELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Anomeh Eivazian	TELEPHONE: (323) 981-3391
LICENSING EVALUATOR SIGNATURE:	DATE: 09/05/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/05/2023

LIC809 (FAS) - (06/04)

Page: 4 of 6

Document Has Been Signed on 09/05/2023 10:59 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
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: ZOGRABYAN FAMILY CHILD CARE	FACILITY NUMBER: 198017819
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 09/05/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1596.8662(b)(1)

Administration of Child Day Care Licensing

(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on licensee's file review, the licensee did not comply with the section cited above and did not have current required mandated reporter training certificate on file which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 10/05/2023
	Plan of Correction
1 2 3 4	Per licensee, she will complete the required mandated reporter training by 10/05/23 and a copy of certificate will be submitted to LPA via email.

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: Christina Gabelman	TELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Anomeh Eivazian	TELEPHONE: (323) 981-3391
LICENSING EVALUATOR SIGNATURE:	DATE: 09/05/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/05/2023

LIC809 (FAS) - (06/04)

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