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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198018388
Report Date: 05/12/2023
Date Signed: 05/12/2023 12:22:20 PM


Document Has Been Signed on 05/12/2023 12:22 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
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754



FACILITY NAME:SUKIASYAN FAMILY CHILD CAREFACILITY NUMBER:
198018388
ADMINISTRATOR:SUKIASYAN, KARMENFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(818) 396-0451
CITY:GLENDALESTATE: CAZIP CODE:
91205
CAPACITY:14CENSUS: 0DATE:
05/12/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:35 AM
MET WITH:Karmen Sukiasyan, LicenseeTIME COMPLETED:
12:40 PM
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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 05/12/23. LPA arrived at the facility at 10:35 AM and met with Karmen Sukiasyan, Licensee who guided analyst on a tour of the facility. A COVID 19 risk assessment was conducted prior to entering the facility. Per licensee, Karmen Sukiasyan facility hours are Monday to Friday from 7:00 a.m. to 11:00 p.m. LPA provided a copy of Entrance Checklist—Family Child Care Home (LIC126) to licensee.

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. During this inspection individuals who reside in the home were discussed and notes on Confidential Name List (LIC811) and attached to this report.

At 11:00 a.m., Licensee took this LPA on a tour of the home. LPA was toured through the interior starting with the living room, LPA observed electric outlets were covered in the living room. LPA observed wall heather in the living room was screened to prevent access. LPA observed sofas, a coffee table, children tables, chairs and toys 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 under the sink where licensee stores cleaning compounds. LPA observed the required 2A 10BC fire extinguisher was anchored to the wall by the kitchen, it was purchased on 01/30/23 as read by LPA from the receipt. Licensee tested the carbon monoxide and smoke detectors in the living room. It sounded off the alarms and heard by LPA to be functional.
REPORT CONTINUES ON NEXT PAGE 1 of 4
SUPERVISOR'S NAME: Christina GabelmanTELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Anomeh EivazianTELEPHONE: (323) 981-3391
LICENSING EVALUATOR SIGNATURE:
DATE: 05/12/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/12/2023
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 4


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: 05/12/2023
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 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 side yard fenced. Currently, children are using the side yard for outdoor play time. 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. The licensee states that supervision is always provided. Per licensee, she will take the children to Maple Park, which is located at 820 E. Maple Street, Glendale, CA 91205 for outdoor activity. A written declaration submitted to LPA during this inspection.

Per Licensee, Karmen Sumiasyan at 11:40 a.m there are no pets, weapons, firearms, pools, spas, hot tubs, fish ponds, or similar bodies of water on the premises. Per licensee, she provides transportation.

The licensee was observed to be operating within the licensed capacity and is not exceeding the required limitations during this inspection. Per licensee, currently she has 6 after-school children enrolled in her daycare. All adults present have obtained a criminal record clearance on Licensing Information System (LIS). Per licensee, Karmen Sukiasyan 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.

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 05/2024. Licensee, Karmen Sukiasyan completed required mandated reporter training on 04/06/22. There are first aid supplies available on the premises in the kitchen. LPA advised licensee that if a child shows signs of illness he/she/they shall be separated from other children.
REPORT CONTINUES ON NEXT PAGE 2 of 4
SUPERVISOR'S NAME: Christina GabelmanTELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Anomeh EivazianTELEPHONE: (323) 981-3391
LICENSING EVALUATOR SIGNATURE:

DATE: 05/12/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/12/2023
LIC809 (FAS) - (06/04)
Page: 2 of 4
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: 05/12/2023
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At 11:55 a.m., facility roster was reviewed and completed. Per licensee currently there are 6 children enrolled. LPA reviewed 5 children's records, including emergency information from 6 enrolled children, and all 5 reviewed files were completed. The licensee has 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 02/03/23. Emergency Disaster Plan, Parent’s Rights Poster and the Facility License were observed to be posted at the wall in the dining area.

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 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 currently she does not provide care to infants. Licensee states that if an infant is enrolled, the infant will sleep in the living room where they are constantly supervised. Appropriate sleeping arrangements and cribs will be available. (one crib for each infant in care is required). Cribs or play yard shall not hinder the entrance or exit from the sleeping space , mattresses shall be firm and covered with a fitted sheet that overlaps the underside so it cannot be dislodged. Cribs and play yards shall be free of loose articles and objects. No objects shall be hanging above or attached to the side of the crib. LPA did not observe any infants swaddled while in care. 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 4
SUPERVISOR'S NAME: Christina GabelmanTELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Anomeh EivazianTELEPHONE: (323) 981-3391
LICENSING EVALUATOR SIGNATURE:

DATE: 05/12/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/12/2023
LIC809 (FAS) - (06/04)
Page: 3 of 4
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: 05/12/2023
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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.
At this time, the licensee is in compliance with California Title 22 Regulations. Therefore, there are no citations being issued today from the areas that were inspected today.

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.
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
Exit interview conducted and report was reviewed with the Licensee, Karmen at 12:40 p.m..
REPORT END 4 of 4
SUPERVISOR'S NAME: Christina GabelmanTELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Anomeh EivazianTELEPHONE: (323) 981-3391
LICENSING EVALUATOR SIGNATURE:

DATE: 05/12/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/12/2023
LIC809 (FAS) - (06/04)
Page: 4 of 4