198020697-12-3-2020-33-CC-AEIN-BVXSWB-20201203131403

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198020697
Report Date: 12/03/2020
Date Signed: 12/03/2020 01:14:16 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:	MIRIMANYAN FAMILY CHILD CARE		FACILITY NUMBER:	198020697
ADMINISTRATOR:	MARIA MIRIMANYAN		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(323) 804-3626
CITY:	GLENDALE	STATE: CA	ZIP CODE:	91202
CAPACITY:	14	CENSUS: 0	DATE:	12/03/2020
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME BEGAN:	11:00 AM
MET WITH:	Maria Mirimanyan, Applicant		TIME COMPLETED:	01:30 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	PRELICENSING INSPECTION CONDUCTED IN ARMENIAN Licensing Program Analyst (LPA) Anomeh Eivazian conducted a pre-licensing inspection today. LPA met with Maria Mirimanyan, Applicant who guided analyst on a tour of the facility at 11:00 a.m.. Family members residing in the home are 2 adults and 0 children. During this inspection Ashot Barseghyan, applicant's husband was also present in the home. The applicant is requesting a large family child care home license. Per applicant operation hours will be 7 days a week, 24 hours a day for less than 24 hours a day. Applicant states she will care for children 0-13 years old. Previously applicant was licensed at 2174 E. Chevy Chase Dr., Glendale , CA 91206 with facility number 198017808. Fire Clearance for Large Family Child Care was granted on 11/19/2020. All areas identified on the facility sketch were inspected at 11:10 a.m.. This is a two home. The second floor consists of living room, dining room, kitchen, two bedrooms, and one bathroom. The first floor consists of one room (daycare room), 1 walking closet, 1 bathroom, laundry room, garage, front yard, and backyard (fenced). Areas that are accessible to children are as follows: First floor 1 room (daycare room), bathroom in the first floor and backyard (fenced). Areas off limits based on facility sketch submitted to children and parents include: Entire second floor which consists of living room, dining room, kitchen, two bedrooms, and one bathroom, garage, laundry room, and front yard. Rooms that are off-limits need to be made inaccessible during operating hours Per applicant parent will enter the facility through the side gate which leads to the drive way, backyard and first floor daycare room. Per applicant at 11:40 a.m. children will use the backyard (fenced) for outdoor activity. Children will be physically and visually supervised at all times. The applicant does understand that licensing staff may have access to off-limit areas during inspection visit if necessary. REPORT CONTINUES ON NEXT PAGE 1 of 4

SUPERVISOR'S NAME: Christina Gabelman	TELEPHONE: (323) 854-8930
LICENSING EVALUATOR NAME: Anomeh Eivazian	TELEPHONE: (323) 981-3391
LICENSING EVALUATOR SIGNATURE:	DATE: 12/03/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/03/2020

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: MIRIMANYAN FAMILY CHILD CARE	FACILITY NUMBER: 198020697
	VISIT DATE: 12/03/2020

NARRATIVE

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At 11:10 am, the applicant began touring LPA’s through the home starting with the entry way of second floor (off-limit areas) which consists of living room, dining room, 1 bathroom, kitchen and two bedrooms and did not observe any hazards. During this inspection LPA observed a safety gate was installed to the stairs by the kitchen which leads to the first floor to make the second floor inaccessible to children. Next LPA walked through the stairs to the first floor daycare room and LPA observed electric outlets were covered. LPA observed children toys and tables in daycare room. Next LPA toured the walking closet and observed applicant locked the door. Next LPA toured the bathroom and did not observe any hazards. Next LPA toured the laundry room(off-limit) and observed a safety door knob on the laundry door. LPA observed a door in the daycare room was closed which leads to the second floor. LPA observed the required 2A 10 BC fire extinguisher was in the hallway of first floor which leads to the second floor and it was purchased on 10/22/2020, as read by LPA from the receipt. Applicant also tested the carbon monoxide detractor in the hallway of first floor and smoke detector in the daycare room at 12:10 p.m.. It sounded off the alarm and heard by LPA to be functional. Next LPA toured the backyard (fenced) and did not observed any hazards. Next LPA toured the off-limits garage and did not observe any hazards.

The applicant states at 12:20 p.m. that she will provide food for children in care. Applicant was advised at that if food is brought from the children’s homes, all containers must be labeled with child’s name and properly stored or refrigerated.

Per applicant, at 12:25 p.m, there are no pets, weapons, firearms or bodies of water on the premises. There are toys available for children.

Applicant has proof of CPR and First Aid training as indicated on the certificate. The applicant does have proof of Health and Safety training (completion date: 08/04/2017), Lead Poisoning Prevention completion date: 11/17/2020, Pediatric First Aid and CPR (ex. 09/2021).

The following was discussed with the 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. Failure to obtain a criminal record background check clearances prior to initial presence in the home will result in an immediate $100.00 dollar or more per day Civil Penalty.
REPORT CONTINUES ON NEXT PAGE 2 of 4

SUPERVISOR'S NAME: Christina Gabelman	TELEPHONE: (323) 854-8930
LICENSING EVALUATOR NAME: Anomeh Eivazian	TELEPHONE: (323) 981-3391
LICENSING EVALUATOR SIGNATURE:	DATE: 12/03/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/03/2020

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: MIRIMANYAN FAMILY CHILD CARE	FACILITY NUMBER: 198020697
	VISIT DATE: 12/03/2020

NARRATIVE

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-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 adult/infant CPR & Pediatric First Aid certification and a valid criminal record clearance associated to the facility license.
-A current roster of children enrolled must be available and maintained for a period of three years, even after children no longer are attending the facility.
-Annual fees must be paid promptly and by the due date or a late fee shall be assessed and/or the License shall be terminated.
-The fire extinguisher type 2A-10BC must be serviced annually or as often as necessary and smoke and carbon monoxide detectors should check and batteries replaced as needed.
-Changes should be reported to the Department as soon as they occur such as construction, remodeling, telephone number changes and/or if you move from your home.
-Any unusual incidents or injuries must be reported to the Department within 24 hours via telephone and within seven (7) days in writing. (use LIC624B for written report)
-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.
-Dog(s) and or pets are recommended to be isolated from children in care.
- No smoking, No infant walkers, No Johnny jumpers, No saucer chairs, No trampolines 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.
- Applicant shall reveal each facility license number in all advertisements, publications or announcements with the intent to attract clients.
- Emergency Disaster Plan, Parent’s Rights Poster and the Facility License are required to be posted.
Infant Care: Applicant states at 11:43 a.m. that she does not care for infants. LPA advised the applicant to sleep infants where they can be directly supervised at all time. LPA advised the applicant to sleep infants where the infant can be directly supervised and advised against sleeping infants in a separate room. LPA reviewed SIDs, Never Shake A Baby, and safe sleeping practices. Infants should sleep mouth up, on their backs, free of clutter surrounding their sleeping space. Safe sleep concepts were provided.

REPORT CONTINUES ON NEXT PAGE 3 of 4

SUPERVISOR'S NAME: Christina Gabelman	TELEPHONE: (323) 854-8930
LICENSING EVALUATOR NAME: Anomeh Eivazian	TELEPHONE: (323) 981-3391
LICENSING EVALUATOR SIGNATURE:	DATE: 12/03/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/03/2020

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: MIRIMANYAN FAMILY CHILD CARE	FACILITY NUMBER: 198020697
	VISIT DATE: 12/03/2020

NARRATIVE

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Medication: 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 applicant, there are no dual licenses at this address. Applicant’s email address was obtained during this inspection. The applicant was advised that email may be public information. Per applicant, she does not carry liability insurance or a bond in accordance with standard established by Family Child Care statue.
The applicant and all adults residing in the home have proof of immunization against influenza, pertussis, and measles. Applicant is exempt from required mandated reporter training due to language barrier. www.mandatedreporterca.com.

During this inspection LPA discussed PIN 20-06 CCP, Social And Physical Distancing Guidance And Healthy Practices For Child Care Facilities In Response To The Global Coronavirus (COVID-19) Pandemic Written In Collaboration With The California Department Of Education and reviewed Child Care Covid-19 Self Assessment.
LPA consulted and explained Child Abuse Reporting, Effects of Lead Exposure Flyer, Updated Patent’s Rights Poster with Complaint Hotline information, Capacity Handout (Small & Large) was provided during this inspection. LPA advised the applicant how to access forms, regulations and quarterly updates, and Provider Information Notices (PIN) on the Child Care Licensing website at: www.ccld.ca.gov. LPA reviewed and issued the Forms/Records to Keep in Your Family Child Care Home (LIC 311D) and provided the following forms:
CHILDREN FORMS/RECORDS , FACILITY FORMS/RECORDS , INFORMATION TO BE POSTED IN YOUR FAMILY CHILD CARE HOME
Final review of application will be completed prior to licensure.
Once licensed, the applicant is required to adhere to the terms and limitations stated on the license. A copy of this report and all other Licensing reports must be made available to the public for 3 years. The applicant’s signature on this report acknowledges that they have signed the Application for a Family Child Care Home License (LIC 279) under the penalty of perjury that the statements on the application and any attachments are correct. Exit interview was conducted with Maria Mirimanay Applicant at 1:30 p.m. who is in agreement with the above.
REPORT END 4 of 4

SUPERVISOR'S NAME: Christina Gabelman	TELEPHONE: (323) 854-8930
LICENSING EVALUATOR NAME: Anomeh Eivazian	TELEPHONE: (323) 981-3391
LICENSING EVALUATOR SIGNATURE:	DATE: 12/03/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/03/2020

LIC809 (FAS) - (06/04)

Page: 4 of 4