198020342-6-22-2021-33-CC-AEIN-C48PFW-20210622111724

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198020342
Report Date: 06/22/2021
Date Signed: 06/22/2021 11:17:34 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:	DAVOIAN FAMILY CHILD CARE		FACILITY NUMBER:	198020342
ADMINISTRATOR:	ASTKHIK DAVOIAN		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(818) 223-7516
CITY:	GLENDALE	STATE: CA	ZIP CODE:	91205
CAPACITY:	14	CENSUS: 12	DATE:	06/22/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	08:30 AM
MET WITH:	Astkhik Davoian, Licensee		TIME COMPLETED:	11:30 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	ANNUAL INSPECTION CONDUCTED IN ARMENIAN Licensing Program Analyst (LPA) Anomeh Eivazian conducted an unannounced annual inspection to the above facility on 06/22/2021. LPA arrived at the facility at 8:30 AM and met with Astkhik Davoian, Licensee who guided analyst on a tour of the facility. Also present during this inspection, were Silva Khachatryan and Hripsime Galstyan, Licensee’s Assistants. Per licensee, facility hours are Monday to Friday from 7:30 a.m. to 6:30 p.m. This is a one story home which consists of 3 bedrooms, 1 bathroom, kitchen, living room (FIREPLACE: inaccessible), detached converted garage which consists of a living room, kitchen, 1 bathroom and 1 bedroom, front yard, and backyard (fenced). The children use the living room, 1 bathroom in the hallway, two bedrooms, kitchen, and backyard (fenced). Per licensee, areas off limits to children and parents include: 1 bedroom, front yard and entire detached converted garage. LPA did not observe stairs in the home during this inspection. Per licensee currently the detached converted garage is empty and no one lives there. Per licensee, currently she uses the converted detached garage as a storage. A written declaration obtained from licensee during this inspection that daycare children are not allowed in detached converted garage. An updated application form, LIC 279 submitted during this inspection. During this inspection individuals who reside in the home were discussed and notes on Confidential Name List (LIC811) and attached to this report. All areas identified on the facility sketch that are accessible for children to use were inspected for safety, comfort, and cleanliness. At 8:45 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 fireplace to prevent access. LPA observed 12 children (2 being infants) were present in the living room with licensee's assistants. LPA observed children toys in the living room. A safety gate was installed to the kitchen entrance to prevent access. Next LPA toured the first daycare bedroom adjacent to the living room and observed children chairs and a table in the bedroom and it was set up as a classroom. REPORT CONTINUES ON NEXT PAGE 1 of 4

SUPERVISOR'S NAME: Christina Gabelman	TELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Anomeh Eivazian	TELEPHONE: (323) 981-3391
LICENSING EVALUATOR SIGNATURE:	DATE: 06/22/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/22/2021

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: DAVOIAN FAMILY CHILD CARE	FACILITY NUMBER: 198020342
	VISIT DATE: 06/22/2021

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Next LPA toured the second daycare bedroom adjacent to the kitchen and observed five children bed and two pack'n plays. Next LPA toured the one bathroom in the hallway and observed child proof safety latches on the cabinet under the sink. The restroom that children use was observed to be safe and sanitary. Next LPA toured the kitchen and observed children table and chairs, two high chairs, one adult table and four chairs in the kitchen. Per licensee, children either eat outside or in the kitchen. LPA observed child proof safety latches on the cabinets where licensee stores sharp items and cleaning compounds. There are first aid supplies available on the premises in the kitchen. LPA observed the required 2A 10BC fire extinguisher were anchored to the wall by the entrance door and in the kitchen. There were serviced on 07/07/2020 as read by LPA from the service tag. Licensee tested the carbon monoxide and smoke detectors in the hallway of bedrooms. Both sounded off the alarms and heard by LPA to be functional. 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 backyard fenced. Currently, children are using the back yard (fenced) for outdoor play time. 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. LPA observed the off-limit back of backyard and off-limit detached converted garage in he backyard is separated by a gate to make it inaccessible to the children. LPA toured the off-limit detached converted garage and observed children table, chairs, beds and some supplies. Per licensee she is using the off-limit converted detached garage as a storage.

Per Licensee, 9:45 a.m there are no pets, weapons, firearms, pools, spas, hot tubs, fish ponds, or similar 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). Per licensee, currently she has two assistants.
The licensee has completed training on preventive health practices including Pediatric First Aid and CPR. The licensee's Pediatric First Aid and CPR expires on 09/22/2022. Licensee, completed required mandated reporter training on 08/26/2019. 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 Gabelman	TELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Anomeh Eivazian	TELEPHONE: (323) 981-3391
LICENSING EVALUATOR SIGNATURE:	DATE: 06/22/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/22/2021

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: DAVOIAN FAMILY CHILD CARE	FACILITY NUMBER: 198020342
	VISIT DATE: 06/22/2021

NARRATIVE

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At 10:00 a.m., facility roster was reviewed and completed. Per licensee currently there are 14 children enrolled. LPA reviewed six children's records, including emergency information from 14 enrolled children, and all six reviewed files were completed.

The licensee and her two assistants have 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 06/07/2021.

Emergency Disaster Plan, Parent’s Rights Poster and the Facility License were observed to be posted at the board in the living room.

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 stays at the facility during operation hours.

INFANT CARE: Licensee states that she is currently caring for infants. Licensee states that infants sleep in the daycare bedroom where they are constantly supervised. Appropriate sleeping arrangements and cribs were observed. (one crib for each infant in care was observed). Cribs or play yard did not hinder the entrance or exit from the sleeping space in the bedroom, mattresses shall be firm and covered with a fitted sheet that overlaps the underside so it cannot be dislodged. Cribs and play yards were observed to be free of loose articles and objects. No objects were observed to 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 Gabelman	TELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Anomeh Eivazian	TELEPHONE: (323) 981-3391
LICENSING EVALUATOR SIGNATURE:	DATE: 06/22/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/22/2021

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: DAVOIAN FAMILY CHILD CARE	FACILITY NUMBER: 198020342
	VISIT DATE: 06/22/2021

NARRATIVE

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Medication: Incidental Medical Services (IMS) policy was discussed at 10:30 a.m. The licensee states that she will provide IMS. Per licensee, there are no children enrolled that require IMS at this time. 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.

Per licensee she carries liability insurance with standard established by Family Child Care statue.

LPA issued the Confidential Names List (LIC 811) to the licensee during this inspection. The Confidential Names List documents the children and staff names that their files were reviewed during this inspection.

LPA advised the licensee to access forms, regulations and quarterly updates online at: www.ccld.ca.gov. LPA also discussed the Provider Information Notices (PINS) on Safe Sleep Awareness: PIN 19-02-CCP, COVID FAQ - PIN 20-11-CCP, Required Lead Testing: PIN 20-01 CCP Effects of Lead Exposure, and Guardian User Account Access - PIN 20-20-CCLD.

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.

LPA inquired into the licensee’s practices related to COVID-19. Licensee stated that they practice hygiene such as hand washing with the children. Licensee has hand sanitizer available in the drop off area and inside her home. Licensee states they practice social distancing with children, take children temperature daily, licensee and staff wear masks all the times and teaching children about wearing proper face covering.

Exit interview was conducted with Licensee, Astkhik Davoian at 11:30 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 4 of 4

SUPERVISOR'S NAME: Christina Gabelman	TELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Anomeh Eivazian	TELEPHONE: (323) 981-3391
LICENSING EVALUATOR SIGNATURE:	DATE: 06/22/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/22/2021

LIC809 (FAS) - (06/04)

Page: 4 of 4