198020702-12-13-2021-33-CC-AEIN-C9NRWD-20211213122257

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198020702
Report Date: 12/13/2021
Date Signed: 12/13/2021 12:23:06 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:	HAKOBYAN FAMILY CHILD CARE		FACILITY NUMBER:	198020702
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY:	8	CENSUS: 0	DATE:	12/13/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	08:40 AM
MET WITH:	Hasmik Hakobyan, Licensee		TIME COMPLETED:	12:40 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	ANNUAL INSPECTION CONDUCTED IN ARMENIAN Licensing Program Analyst (LPA) Anomeh Eivazian conducted an unannounced annual inspection to the above facility on 12/2021. LPA arrived at the facility at 8:40 AM and met with Hasmik Hakobyan, Licensee who guided analyst on a tour of the facility. Also present during this inspection, was Avetik Hakobyan and Nunufar Hakobyan, licensee's daughter. Per licensee, Hasmik Hakobyan facility hours are Monday to Saturday from 6:30 a.m. to 10:00 p.m. This is a one story home located on the first level. The home consists of 3 bedrooms, 2 restrooms, living room and dining room (daycare area), office, kitchen, front yard, backyard (fenced), and garage. There is a screen door with (1) lock on the front entrance. In addition, the wrought iron railings and openings leading to front door are covered with mesh. Per licensee at 9:00 a.m. the children use the Living room and dining room (daycare rooms), kitchen, bedroom #1 and backyard (fenced). There is a fireplace in the living room which has been blocked off to prevent access to children. Per licensee, children only walk through the kitchen to go to the backyard. Per licensee parents use the main entrance door which leads to the living room (daycare room) and side gate which leads to the backyard to enter the facility. Per licensee areas off limits to children and parents include: Two bedrooms, 1 bathroom in the master bedroom, office, garage, front yard, and back of backyard. LPA did not observe 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 9:00 a.m., Licensee took this LPA on a tour of the home. LPA was toured through the interior starting with the living room and dining room (daycare classrooms), LPA observed sofas, children tables and chairs, toys and a TV in the living room and dining room. LPA observed all electrical outlets were 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: 12/13/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/13/2021

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: HAKOBYAN FAMILY CHILD CARE	FACILITY NUMBER: 198020702
	VISIT DATE: 12/13/2021

NARRATIVE

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covered in living room and dining room. Next LPA toured the daycare bedroom #1, adjacent to the dining room and observed a full size bed, 4 napping cots and one pack' n play. Next LPA toured the bathroom in the hallway of bedrooms and did not observe any hazards. Next LPA toured the one off-limit bedroom in the hallway and did not observe any hazards. Next LPA toured the kitchen and observed a gate was installed to the kitchen to make it inaccessible the the children. LPA observed child proof safety latches on the cabinets where licensee stores sharp items and cleaning compounds. Next LPA toured the off-limit office, master bedroom and bathroom in the master bedroom and did not observe any hazards. LPA observed licensee's family members personal belongings in the home. LPA observed the required 2A 10BC fire extinguisher was anchored to the wall by the half bathroom entrance door . It was serviced on 10/03/21 as read by LPA from the service tag. Licensee tested the carbon monoxide and smoke detectors in the living room. It 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 for outdoor play time. The outdoor play area was observed to be fenced. 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. Outdoor playground ground are cement and artificial grass. LPA observed off-limit areas in the backyard was separated by safety gates. Next LPA toured the off-limit garage and did not observe any hazards. Per licensee, she keeps the garage door closed all the times during day care hours. The licensee states that supervision is always provided.

Per Licensee, Hasmik Hakobyan at 10:10 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. During this inspection no children was present in the home. All adults present have obtained a criminal record clearance on Licensing Information System (LIS). Per licensee, Hasmik Hakobyan at 10:15 a.m. currently she has two assistants. Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

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: 12/13/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/13/2021

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: HAKOBYAN FAMILY CHILD CARE	FACILITY NUMBER: 198020702
	VISIT DATE: 12/13/2021

NARRATIVE

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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 10/2022. Licensee, Hasmik Hakobyan is exempt from required Mandated Reporter training due to language barrier. There are first aid supplies available on the premises in the living room in a closet. LPA advised licensee that if a child shows signs of illness he/she/they shall be separated from other children.

At 10:50 a.m., facility roster was reviewed and completed. Per licensee currently there are 10 children enrolled. LPA reviewed 10 children's records, including emergency information from 10 enrolled children, and all 10 reviewed files were completed. The licensee has 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 12/10/2021. Emergency Disaster Plan, Parent’s Rights Poster and the Facility License were observed to be posted at the wall by the entrance. 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, her husband smokes but in the street and off-limit area. There is telephone service via a cellphone that is used and the cellphone stays at the facility during operation hours. 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 10 reviewed files.

SAFE SLEEP: LPA discussed the safe sleep regulations with licensee, Hasmik Hakobyan and discussed the Child Care Licensing Safe Sleep webpage at http://www.cdss.ca.gov/inforescources/child-care-licensing/public-information-and-resoucrces/safe-sleep as an additional resource. LPA also informed licensee of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at http://www/cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment. Boppy recall: https://www.cpsc.gov/Recalls/2021/The-Boppy-Company-Recalls-Over-3-Million-Original-Newborn-Loungers-Boppy-Preferred-Newborn-Loungers-and-Pottery-Barn-Kids-Boppy-Newborn-Loungers-After-8-Infant-Deaths-Suffocation-Risk

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: 12/13/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/13/2021

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: HAKOBYAN FAMILY CHILD CARE	FACILITY NUMBER: 198020702
	VISIT DATE: 12/13/2021

NARRATIVE

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INFANT CARE: Licensee states that she is currently caring for infants who are over 12 months.. Licensee states that infants sleep in the one 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.
Medication: Incidental Medical Services (IMS) policy was discussed. The licensee states that she will provide IMS. Per licensee, there are no children enrolled that require IMS at this time. 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.
LPA advised the licensee to access forms, regulations and quarterly updates online at: www.ccld.ca.gov.
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, staff, children 2 years above wear masks all the times indoor and teaching children about wearing proper face covering.
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.
The Notice of Site Visit (LIC 9213) was given and must remain posted for 30 days.
To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experienced. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding inspection tools and methods, please visit the Program website at www.cdss.gov/inforesouces/community-care-liceinsing/inspection-process . Exit interview conducted and report was reviewed with the Licensee, Hasmik Hakobyan at 12:40 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: 12/13/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/13/2021

LIC809 (FAS) - (06/04)

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