198019932-4-3-2023-33-CC-JMOA-CQJPMJ-20230403112626

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198019932
Report Date: 04/03/2023
Date Signed: 04/03/2023 11:26:38 AM

Document Has Been Signed on 04/03/2023 11:26 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:	MAYILYAN FAMILY CHILD CARE		FACILITY NUMBER:	198019932
ADMINISTRATOR:	TARON MAYILYAN		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(818) 749-1188
CITY:	GLENDALE	STATE: CA	ZIP CODE:	91205
CAPACITY:	14	CENSUS: 11	DATE:	04/03/2023
TYPE OF VISIT:	Case Management - Other	UNANNOUNCED	TIME BEGAN:	09:46 AM
MET WITH:	Marine Adamyen		TIME COMPLETED:	11:45 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	Licensing Program Analyst's (LPAs) Judy Mora and Mary Silva conducted an unannounced Case Management inspection on this date. Licensing staff met with Marine Adamyen, Licensee's Assistant, who guided licensing staff on a tour of the facility at approximately 08:47 AM. Also present, was Marine Sosyan, Licensee of facility #198018963. There were 05 children present at the time of arrival. Additional children arrived during this inspection. Marine Sosyan left to the facility next door and returned approximately 10 minutes later. Licensee, Taron Mayilan, arrived at approximately 9:06 AM. At approximately 09:30 AM an additional assistant, Gayane Chobanyan, arrived at the facility. Per Licensee hours of operation vary but are usually Mon-Fri 7:00 AM - 7:00 PM. Individuals residing in the home have been discussed and noted. All adults present in the home have obtained a criminal record clearance or exemption. The purpose of this inspection is to ensure that the facility is in compliance with Title 22 regulations and the Health and Safety Code. The facility was placed on a Compliance Plan on 09/08/21 and there was also a Non Compliance Conference held on 11/09/2022. This is a one story home which consists of 03 bedrooms, 1 1/2 bathrooms, kitchen, living room, dining room, laundry area, detached garage, front yard and backyard (fenced). Areas off limits to children and parents include: kitchen, one bedroom, one restroom and detached garage. Children use the bathroom next to the dining room. There is a kiddie gate blocking access to kitchen on one side. LPA Mora reminded Licensee, that they were advised during the inspection held on 03/17/22 to place an additional kiddie gate in the other kitchen doorway. Licensee could not find the kiddie gate during this inspection. Licensee will send LPA Mora a photo once it is installed. The Licensee's yard is shared with Mayilyan and Sosyan FCC, license #198018963. Per Licensee the children play outside from 10:00 AM to 11:30 AM. Food is provided by Licensee. Transportation services are provided if needed for school age children. *REPORT CONTINUES ON NEXT PAGE

SUPERVISOR'S NAME: Claudia Guangorena	TELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Judy Mora	TELEPHONE: (323) 896-6847
LICENSING EVALUATOR SIGNATURE:	DATE: 04/03/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/03/2023

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: MAYILYAN FAMILY CHILD CARE	FACILITY NUMBER: 198019932
	VISIT DATE: 04/03/2023

NARRATIVE

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Licensing staff observed the following required posted documentation in the main entry way of the facility: Facility License, Publication (PUB) 394- Notification of Parent Rights and Licensing Form (LIC) 9148- Earthquake Preparedness form. LPA reviewed facility records for LIC 9040- Facility Roster, LIC 610- Facility Disaster Plan and Disaster drill log. Last drill was conducted on 03/24/2023.

At 9:45 AM, Tigran Mayilyan, came into the facility through the back door and stayed approximately two minutes while speaking to Marine Sosyan. At 10:55 AM, Tigran returned to the facility, for approximately three minutes to speak to Marine Sosyan and Taron Mayilyan. All conversations held were conducted in Armenian.

Smoke and carbon monoxide detectors in the hallway were tested and are operable. Fire extinguisher indicated fully charged, purchased on 11/28/2022 (receipt attached). The home maintains telephone service via cell phone. The home is observed to be clean and orderly. There are toys and other age appropriate material available for children.

Licensing staff observed a fireplace, in the living room that is off limits to children. Licensing staff observed that there are no detergents, cleaning compounds or medication's accessible. Licensee states that there are no poisons stored in the home. Isolation area for sick children waiting to be picked up is in one of the bedrooms if necessary, away from the other children. Per Licensee there are no firearms or weapons stored in the home.

Infant Care: Per Licensee, there are currently no infants enrolled. Licensing staff observed that there are no infants listed on the facility roster. LPA informed licensee of the Safe sleep regulations, including LIC 9227 Infant Sleep Plan for infants under 12 months, 15-minute sleep check documentation for infants 0-24 months.

Currently children are using the backyard yard for outdoor play. The outdoor play area was observed to be fenced. Licensing staff observed that the outdoor yard has toys and other materials for children to play with.

Children’s records were reviewed for (LIC) 282- Affidavit Regarding Liability Insurance, Immunization's Records, LIC 700- Identification and Emergency Information, LIC 627- Consent for Medical Treatment, LIC 995A Notification of Parents’ Rights.

*REPORT CONTINUES ON NEXT PAGE

SUPERVISOR'S NAME: Claudia Guangorena	TELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Judy Mora	TELEPHONE: (323) 896-6847
LICENSING EVALUATOR SIGNATURE:	DATE: 04/03/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/03/2023

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: MAYILYAN FAMILY CHILD CARE	FACILITY NUMBER: 198019932
	VISIT DATE: 04/03/2023

NARRATIVE

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Children's files were reviewed to ensure that a LIC 9224, Acknowledgement of Receipt of Licensing Report is on file for office meeting held on 11/09/2022 and for substantiated complaint on 03/20/23. All children have the LIC 9224's on file.

Staff records were reviewed for approved Pediatric First Aid and CPR certification, LIC 508- Criminal Record Statement, LIC 9108- Statement Acknowledging Requirement to Report Child Abuse and current Mandated Reporter Training Certificate. The Licensee has current Pediatric First Aid and CPR which expires 08/14/23. The Licensee also has the current mandated reporter certificate, expires 08/11/23. Licensee's assistant, Marine Adamyen, has current Pediatric First Aid & CPR, expires 03/26/24 and Mandated Reporter Certificate, expires 03/27/24.

Incidental Medical Services (IMS):
Incidental Medical Services (IMS) policy was discussed. Per Licensee, there are no children on medications. 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 Center and the ADA, available at: http://www.ada.gov/childqanda.htm

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.

LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/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.

There were no deficiencies issued. A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the Licensee, Taron Mayilyan.

*END OF REPORT

SUPERVISOR'S NAME: Claudia Guangorena	TELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Judy Mora	TELEPHONE: (323) 896-6847
LICENSING EVALUATOR SIGNATURE:	DATE: 04/03/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/03/2023

LIC809 (FAS) - (06/04)

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