198020572-8-12-2021-33-CC-AEIN-C5TRT3-20210812131740

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198020572
Report Date: 08/12/2021
Date Signed: 08/12/2021 01:17:49 PM

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:	ASRYAN FAMILY CHILD CARE		FACILITY NUMBER:	198020572
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY:	8	CENSUS: 5	DATE:	08/12/2021
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME BEGAN:	12:20 PM
MET WITH:	Narine Asryan, Licensee		TIME COMPLETED:	01:40 PM

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	CASE MANAGEMENT INSPECTION CONDUCTED IN ARMENIAN Licensing Program Analysts (LPA) Anomeh Eivazian and Steven Tung conducted an unannounced case-management inspection to the above facility on 06/08/2021 due to licensee is requesting a capacity increase. LPAs arrived at the facility at 12:20 PM and met with Narine Asryan, Licensee who guided analyst on a tour of the facility. Per licensee facility hours are Monday to Friday from 7:00 a.m. to 6:00 p.m. For Large Family Child Care the Fire Inspection clearance was granted on 08/06/2021. This is a one story home which consists of 3 bedrooms, 2 bathrooms, kitchen, dining room, living room (FIREPLACE: inaccessible), garage, laundry room, front yard and backyard (fenced). Per licensee at 12:30 p.m. the children use the living room (daycare area), one bathroom in the hallway, dining room, kitchen, laundry room, and front part of backyard (fenced). Per licensee areas off limits to children and parents include: 3 bedrooms, one bathroom in the master bedroom, front yard, back of backyard and garage. LPAs did not observe any stairs in the home. 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 12:30 p.m., Licensee took this LPAs on a tour of the home. LPAs was toured through the interior starting with the living room (daycare area), LPA observed children toys, table, chairs, and napping cots in the living room. LPAs observed five children were sleeping in the living room during this inspection. LPA observed all electrical outlets were covered in living room. Per licensee children only walk through the dining room, kitchen and laundry room to go to the backyard (fenced). LPA observed the required 2A 10BC fire extinguisher was anchored to the wall by the entrance. It was purchased on 06/06/21 as read by LPAs from the receipt. 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: 08/12/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/12/2021

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: ASRYAN FAMILY CHILD CARE	FACILITY NUMBER: 198020572
	VISIT DATE: 08/12/2021

NARRATIVE

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Licensee tested the carbon monoxide in the hallway of bedrooms and smoke detector in the living room. Both sounded off the alarms and heard by LPAs to be functional. LPAs observed a safety gate was installed between the living room and dining room. LPAs toured the dining room and observed an adult dining table, chairs and a sofa in the dining room. Next LPAs toured the kitchen and observed child safety proof latches on the cabinets where licensee stores sharp items and cleaning compounds. Next LPAs toured the three off-limit bedrooms and one bathroom in the master bedroom and did not observe any hazards. LPAs observed a safety gate was installed between the living room and bedrooms. LPAs observed licensee's family members personal belongings in the home. 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 LPAs toured the backyard fenced. Currently, children are using the front part of backyard that is separated by fence from off-limit areas of backyard. The outdoor play area was observed to be fenced. LPAs observed that the outdoor yard has toys and other materials for children to play with. The outdoor playarea ground is covered by artificial grass. LPAs did not observe any objects that can pose a danger to children on the outdoor yard. Next LPAs toured the detached converted garage and off-limit areas of the backyard and did not observe any hazards.

Per Licensee, Narine Asryan at 12:55 p.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 one assistant.

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 05/2022 . Licensee, completed required mandated reporter training on 06/09/2021. There are first aid supplies available on the premises in the living room. LPA advised licensee at 1:05 p.m. 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: 08/12/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/12/2021

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: ASRYAN FAMILY CHILD CARE	FACILITY NUMBER: 198020572
	VISIT DATE: 08/12/2021

NARRATIVE

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At 1:10 p.m., facility roster was reviewed and completed. Per licensee currently there are 5 children enrolled. LPAs reviewed five children's records, including emergency information from 5 enrolled children, and all five reviewed files were completed.
The licensee and her assistant 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 06/17/2021.

Emergency Disaster Plan, Parent’s Rights Poster and the Facility License were observed to be posted at the wall by the entrance.

LPAs 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, her husband smokes after daycare hours in off-limit areas in the backyard. There is telephone service via a cellphone that is used and the cellphone stays at the facility during operation hours.

INFANT CARE: Licensee states that she is not currently caring for infants. Licensee states that if an infant is enrolled, the infant will sleep in the living room (daycare area) where they are constantly supervised. Per licensee she will buy appropriate sleeping arrangements and cribs once she enrol an infant in her daycare. LPA informed licensee that one crib for each infant in care is required. Cribs or play yard can 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 are required to be free of loose articles and objects. No objects can 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: 08/12/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/12/2021

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: ASRYAN FAMILY CHILD CARE	FACILITY NUMBER: 198020572
	VISIT DATE: 08/12/2021

NARRATIVE

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Medication: Incidental Medical Services (IMS) policy was discussed at 1:15 p.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 does not carry liability insurance or a bond in accordance with standard established by Family Child Care statue. Signed statements (LIC282) on five reviewed files.

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.

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. At 1:25 p.m. 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.

The Notice of Site Visit (LIC 9213) was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the Licensee, Narine Asryan at 1:40 p.m..

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: 08/12/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/12/2021

LIC809 (FAS) - (06/04)

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