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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198019932
Report Date: 10/21/2022
Date Signed: 10/21/2022 04:17:35 PM


Document Has Been Signed on 10/21/2022 04:17 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:MAYILYAN FAMILY CHILD CAREFACILITY NUMBER:
198019932
ADMINISTRATOR:TARON MAYILYANFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(818) 749-1188
CITY:GLENDALESTATE: CAZIP CODE:
91205
CAPACITY:14CENSUS: 11DATE:
10/21/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
03:16 PM
MET WITH:Licensee, Taron MayilyanTIME COMPLETED:
04:30 PM
NARRATIVE
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On October 21, 2022 at 3:16PM Licensing Program Analysts (LPAs) Monique Ayala and Bardo Baluyot conducted an unannounced Case Management Inspection A COVID-19 risk assessment was conducted prior to entering the facility. LPAs met with Licensee, Taron Mayilyan. LPAs observed 10 children in care, at 3:24 PM. The purpose of this inspection is to ensure that the facility is in compliance with Title 22 Regulations and the Health and Safety Code.

LPA verified with Parent #1 (P1), parent of Child #1 (C1), who stated (P1)attempted to register (C1) at school for this year but got rejected. Per P1, C1 is on a wait list/registered for Kindergarten for August 2023. Based on P1's information/statement C1 is not currently enrolled in a TK program as stated by Licensee, Taron Mayilyan on 10/6/2022.

Based on the above information, the Department has found that licensee, Taron Mayilyan was not forthcoming about C1 as this would have put the facility over capacity.

A Type A deficiency is being cited today, 10/21/2022. Please see LIC809D

Also, licensing staff informed the licensee Taron Mayilyan to provide a copy of this licensing report dated 10/21/2022 that documents any Type A citation(s) to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

SUPERVISOR'S NAME: Ana ChicoTELEPHONE: (323) 981-3351
LICENSING EVALUATOR NAME: Bardo BaluyotTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:
DATE: 10/21/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/21/2022
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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Document Has Been Signed on 10/21/2022 04:17 PM - 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: MAYILYAN FAMILY CHILD CARE
FACILITY NUMBER: 198019932

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/21/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
11/04/2022
Section Cited

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Conduct Inimical: Conduct in the operation or maintenance of a child care center which is inimical to the health, morals, welfare, or safety of either an individual in or receiving services from the facility or the people of the State of California.This requirement is not met as evidenced by: Based on interview Parent
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#1 (P1) attempted to enroll school Child #1 for this year but was rejected. Per P1, C1 is registered for Kindergarten for August 2023 and is not currently enrolled. This poses an immediate health and safety risk to children in care.

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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: Ana ChicoTELEPHONE: (323) 981-3351
LICENSING EVALUATOR NAME: Bardo BaluyotTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:
DATE: 10/21/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/21/2022
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: 10/21/2022
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The Notice of Site Visit (LIC 9213) – must remain posted for 30 days during the hours of operation after each site visit by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00

Licensee was informed that signing this report acknowledges receipt of the report and is not admission to or agreeing with any of the statements within the content of the report.

An exit interview was conducted, and a copy of this report was provided to licensee, Taron Mayilyan. A copy of Appeal Rights were also provided to licensee and explained that the licensee has 15 days from the day of citation (10/21/2022) to file an appeal to the department.

SUPERVISOR'S NAME: Ana ChicoTELEPHONE: (323) 981-3351
LICENSING EVALUATOR NAME: Bardo BaluyotTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 10/21/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/21/2022
LIC809 (FAS) - (06/04)
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