198020295-6-5-2019-33-CC-CGOZ-BCUPP6-20190605112902

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198020295
Report Date: 06/05/2019
Date Signed: 06/05/2019 11:29:15 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:	HARUTYUNYAN FAMILY CHILD CARE		FACILITY NUMBER:	198020295
ADMINISTRATOR:	ANAHIT HARUTYUNYAN		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(818) 422-4202
CITY:	GLENDALE	STATE: CA	ZIP CODE:	91206
CAPACITY:	14	CENSUS: 0	DATE:	06/05/2019
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME BEGAN:	09:05 AM
MET WITH:	Anahit Harutyunyan, Applicant		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 (LPA) Carlos Gonzalez conducted a Pre-licensing inspection. LPA met with Anahit Harutyunyan, Applicant, who guided Analyst on a tour of the facility. Applicant was previously licensed at 1223 Carlton Dr., Glendale, CA 91205, under facility license number #198019875. Per Applicant, hours of operation will be from Monday thru Saturday, 7:30 AM to 11:00 PM. Applicant states that she will be caring for children 0-14 years of age. All areas identified on the facility sketch were inspected. This is a single story home consisting of 4 bedrooms, 3 bathrooms, living room, dining room area, and kitchen. LPA observed a fireplace in the living room, however there is a metal screen barrier, which is secured with metal screws, to prevent children from gaining access. Children will have access to the living room, dining room area, the bathroom in the hallway area and the two bedrooms, also located in the hallway. Off-limits to children in care are the kitchen, master bedroom with bathroom, and additional bedroom with bathroom. Applicant and minor child, currently reside in the home. Areas that will be used by children were inspected for safety, comfort, cleanliness, telephone service (land line), ventilation and heating. Detergents, cleaning compounds, medicines, sharp objects and other hazardous items that can pose a danger to children were observed to be inaccessible in the areas designated for children. LPA observed poisons and cleaning compounds were kept in the master bathroom (underneath the bathroom sink), which is off-limits to children in care. Children will utilize the outdoor patio, adjacent to the dining room and rear back yard for outdoor play. Applicant was advised that 100% supervision is required at all times when children are playing outdoors. Applicant states that she will providing food for children. Applicant has completed the required Health and Safety Training, Nutrition Training and Pediatric First Aid and CPR which expires on 03/28/2020. Report continues on next page 1 of 3

SUPERVISOR'S NAME: Katherine Harewood	TELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Carlos Gonzalez	TELEPHONE: (323) 981-3381
LICENSING EVALUATOR SIGNATURE:	DATE: 06/05/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/05/2019

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: HARUTYUNYAN FAMILY CHILD CARE	FACILITY NUMBER: 198020295
	VISIT DATE: 06/05/2019

NARRATIVE

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Infant Care: Applicant's state that she will care for infants. LPA advised Applicant to sleep infants where they can be directly supervised at all times and advised against sleeping infants in a separate room. Per Applicant, she will place infant's in the bedrooms, located in the hallway when sleeping.

Incidental Medical Services (IMS): Incidental Medical Services (IMS) policy was discussed. 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.

INFORMATION TO BE POSTED IN YOUR FAMILY CHILD CARE HOME:
Facility License (LIC 203), Emergency Disaster Plan (LIC 610A), Notification of Parent’s Rights (PUB 394). A Notice of Site Visit (LIC 9213): Must be posted for 30 days after each site inspection by a Licensing Program Analyst.
Any Licensing Report documenting a Type “A” deficiency must be posted for 30 days during the hours that children are in care.
Any Licensing Report or other document verifying compliance or non-compliance with the Department’s order to correct a Type “A” deficiency must be posted for 30 days during the hours that children are in care.

LPA advised the applicant how to access forms, regulations and quarterly updates on the Child Care Licensing website at: www.ccld.ca.gov.

LPA advised Applicant's on how to obtain the Department's Quarterly Updates via the following website address: www.childcareadvocatesprogram@dss.ca.gov

Exit interview was conducted with Anahit Harutyunyan, Applicant, who was in agreement with the above.

Report ends page 3 of 3

SUPERVISOR'S NAME: Katherine Harewood	TELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Carlos Gonzalez	TELEPHONE: (323) 981-3381
LICENSING EVALUATOR SIGNATURE:	DATE: 06/05/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/05/2019

LIC809 (FAS) - (06/04)

Page: 3 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: HARUTYUNYAN FAMILY CHILD CARE	FACILITY NUMBER: 198020295
	VISIT DATE: 06/05/2019

NARRATIVE

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There are first aid supplies available. Per Applicant, there are no firearms, weapons, or pets on the premises. LPA did not observe any bodies of water on the premises. The valve on the 2-A:10-B:C fire extinguisher indicates fully charged and was last serviced on 04/29/2019, per the attached service tag. The smoke and carbon monoxide detectors were tested and are operable. There are age appropriate toys available for children.

The following was discussed with Applicant:

· Individuals who are 18 years of age or older living in the home must obtain a criminal record clearance. Individuals within one month of their 18th birthday must be fingerprinted immediately. Civil Penalties will be assessed if not in compliance.
· In the absence of the licensee a qualified adult must be present supervising the children; a qualified adult is an individual who has a valid and current Pediatric First Aid and CPR certification and a valid criminal record clearance associated to the facility license.
· Annual fees must be paid promptly and by the due date or a late fee shall be assessed and/or the License may be terminated.
· The fire extinguisher type 2-A:10-B:C must be serviced annually or as often as necessary. Smoke and carbon monoxide detectors should be checked and batteries replaced as needed.
· Reporting Requirements: Any unusual incidents or injuries must be reported to the Department within 24 hours via telephone and within seven (7) days in writing.
· Fire and safety drills must be performed every six months and documented for review by the Department.
· Smoking is prohibited in a family child care home.
· Children and Staff records must be maintained and updated as needed and must be available for review by the Department.
· NO smoking, NO infant walkers, NO Johnny jumpers, NO saucer chairs, and any other item that falls into that category are not permitted in the facility.
· All adults living and working in the home shall be made of aware of the Departments right to inspection authority, which includes but not limited to the right to enter the home when children are being cared for, interview children and adults and review documentation.
· Licensees shall reveal each facility license number in all advertisements, publications or announcements with the intent to attract clients.

Report continues on next page 2 of 3

SUPERVISOR'S NAME: Katherine Harewood	TELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Carlos Gonzalez	TELEPHONE: (323) 981-3381
LICENSING EVALUATOR SIGNATURE:	DATE: 06/05/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/05/2019

LIC809 (FAS) - (06/04)

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