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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198018388
Report Date: 10/15/2020
Date Signed: 10/15/2020 10:31:12 AM

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:SUKIASYAN FAMILY CHILD CAREFACILITY NUMBER:
198018388
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 0DATE:
10/15/2020
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
08:50 AM
MET WITH:Karmen Sukiasyan, LicenseeTIME COMPLETED:
10:50 AM
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CASE MANAGEMENT INSPECTION CONDUCTED IN ARMENIAN
This was a case management inspection conducted by Licensing Program Analyst (LPA) Anomeh Eivazian. This case management inspection was conducted with Licensee Karmen Sukiasyan in Armenian to address a request for a capacity increase to a Large Family Child Care Home (FCCH) license.
Licensee, Karmen Sukiasyan has been licensed at this address since 04/03/2015. For Large Family Child Care Home Fire Clearance was granted on 09/23/2020.

This is a one story home which consists of 2 bedrooms, 1 bathroom, kitchen,dining room, living room (Wall heather: inaccessible), laundry room adjacent to the kitchen, side yard and front yard (fenced). The children use the living room, 1 bathroom, kitchen,dining room and side yard (fenced). Per licensee, areas off limits to children and parents include: 2 bedrooms, laundry room, and front yard. The licensee provides food for children in care. Family members residing in the home are 2 adults who have clearances on file and 0 children.

At 9:10 a.m., Licensee took this LPA on a tour of the home. LPA was toured through the interior starting with the living room where observed a screen was installed to the wall heater. During this inspection 0 children were present in the home. LPA observed electric outlets were covered in the living room. Next LPA was toured through the dining room and observed a dining table and chairs. Next LPA toured the kitchen and observed safety latches on the cabinets where licensee stores cleaning compounds and sharp items. Next LPA toured the laundry room and observed a sliding door was installed to make the laundry room inaccessible to the children. Next LPA was toured the off-limit 2 bedrooms and did not observe any hazards. Next LPA was toured the one bathroom and observed a safety latch on the cabinet where licensee stores cleaning compounds.
REPORT CONTINUES ON NEXT PAGE 1 of 3
SUPERVISOR'S NAME: Christina GabelmanTELEPHONE: (323) 854-8930
LICENSING EVALUATOR NAME: Anomeh EivazianTELEPHONE: (323) 981-3391
LICENSING EVALUATOR SIGNATURE:

DATE: 10/15/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/15/2020
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 3
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: SUKIASYAN FAMILY CHILD CARE
FACILITY NUMBER: 198018388
VISIT DATE: 10/15/2020
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Licensee showed LPA the fire extinguisher was purchased 01/28/2020 as read by LPA from the receipt. LPA observed one Fire Extinguisher was anchored to the wall in the kitchen. Licensee also tested the carbon monoxide and smoke detectors in the hallway of bedroom. Both sounded off the alarms and heard by LPA to be functional. At 10:00 a.m., licensee toured the side yard area (fenced) and did not observe any hazards. Posting requirements were observed to be posted at the time of inspection by the entrance door in the dining room.

Per licensee parents enter the facility through the main entrance door which leads to the living room.
Per licensee at 10:05 am., there are no pets, weapons, firearms or 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. All adults present have obtained a criminal record clearance on Licensing Information System (LIS). The licensee has proof of current pediatric first aid and CPR (expires: 04/2022). Licensee completed Preventative Health and Safety training on 09/27/2020. Licensee completed required mandated reporter training on 03/03/2020.

At 10:10 a.m., facility roster were reviewed and completed. Per licensee currently there are 8 children enrolled, and all the enrolled children are after school children. LPA reviewed four children's files, and those were completed.

INFANT CARE: Licensee states at 10:10 a.m, that she does care for infants. Any infants in care will stay in the area where the licensee or assistant are. LPA advised the licensee to sleep infants where the infant can be directly supervised and advised against sleeping infants in a separate room. The licensee states that infants sleep inside the home in the living room under direct supervision all the times. LPA reviewed SIDs, Never Shake A Baby, and safe sleeping practices. Infants should sleep mouth up, on their backs, free of clutter surrounding their sleeping space. Safe sleep concepts were provided.


REPORT CONTINUES ON NEXT PAGE 2 of 3
SUPERVISOR'S NAME: Christina GabelmanTELEPHONE: (323) 854-8930
LICENSING EVALUATOR NAME: Anomeh EivazianTELEPHONE: (323) 981-3391
LICENSING EVALUATOR SIGNATURE:

DATE: 10/15/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/15/2020
LIC809 (FAS) - (06/04)
Page: 2 of 3
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: SUKIASYAN FAMILY CHILD CARE
FACILITY NUMBER: 198018388
VISIT DATE: 10/15/2020
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Medication: Incidental Medical Services (IMS) policy was discussed at 10:17 a.m, 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

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 children’s files. The law requires Family Child Care provider to carry liability insurance or bond in the amount of $300,000 annually or to maintain the signed statement in the facility file. .



During this inspection LPA discussed PIN 20-06 CCP, Social And Physical Distancing Guidance And Healthy Practices For Child Care Facilities In Response To The Global Coronavirus (COVID-19) Pandemic Written In Collaboration With The California Department Of Education and reviewed Child Care Covid-19 Self Assessment.

LPA inquired into the licensee’s practices related to COVID-19. Licensee stated that she practices hygiene such as hand washing with the children. Licensee has hand sanitizer available in the drop off area and inside her home. Licensee states she practices social distancing with children.

The home has no need for corrections at this time based today's inspection conducted by LPA Eivazian from the areas that were inspected.



At this time, the licensee is in compliance with California Title 22 Regulations. Therefore, there are no citations being issued today.

Exit interview was conducted with Licensee, Karmen Sukiasyan at 10:50 a.m.. Appeal rights explained & provided. A copy of this report and all other Licensing reports must be made available to the public for 3 years.
REPORT END 3 of 3
SUPERVISOR'S NAME: Christina GabelmanTELEPHONE: (323) 854-8930
LICENSING EVALUATOR NAME: Anomeh EivazianTELEPHONE: (323) 981-3391
LICENSING EVALUATOR SIGNATURE:

DATE: 10/15/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/15/2020
LIC809 (FAS) - (06/04)
Page: 3 of 3