198020781-4-27-2021-33-CC-AEIN-C2GSMW-20210427140038

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198020781
Report Date: 04/27/2021
Date Signed: 04/27/2021 02:01:25 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:	VARDANIAN FAMILY CHILD CARE		FACILITY NUMBER:	198020781
ADMINISTRATOR:	VARDANIAN, KARINE		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(818) 858-8885
CITY:	LA CRESCENTA	STATE: CA	ZIP CODE:	91214
CAPACITY:	14	CENSUS: 0	DATE:	04/27/2021
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	10:15 AM
MET WITH:	Karine Vardanian, 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 on 04/27/2021 at 10:15 a.m.. LPA met with Karine Vardanian Applicant who guided analyst on a tour of the facility. During this inspection individuals who reside in the home were discussed and noted on Confidential Name form (LIC 811). The applicant is requesting a large family child care home license. Per applicant operation hours will be Monday to Friday from 7:30 a.m. to 5:30 p.m.. Applicant states she will care for children 0-13 years old. Fire clearance for Large Family Child Care was granted on 04/23/2021. All areas identified on the facility sketch were inspected. This is a one story home located on the first level. There is a two entrance to the home, one door leads to the main home and one door leads to the day care area (pictures were taken). The home consists of 3 bedrooms, 2 restrooms, living room, two kitchens, laundry room, daycare area, front yard, backyard, and side yards (fenced). Areas that are accessible to children are as follows: Daycare room, kitchen in daycare area, bathroom in the daycare room, backyard and two side yards (fenced). Areas off limits based on facility sketch submitted to children and parents include: Living room, three bedrooms, one bathroom, 1 kitchen, 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 main entrance door which leads to the daycare area. Per applicant at 11:00 a.m. children will use the two side yards and backyard for outdoor activity.. Per applicant 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 if necessary. REPORT CONTINUES ON NEXT PAGE 1 of 5

SUPERVISOR'S NAME: Christina Gabelman	TELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Anomeh Eivazian	TELEPHONE: (323) 981-3391
LICENSING EVALUATOR SIGNATURE:	DATE: 04/27/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/27/2021

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: VARDANIAN FAMILY CHILD CARE	FACILITY NUMBER: 198020781
	VISIT DATE: 04/27/2021

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At 10:20 am, the applicant began touring LPA’s through the main entrance which leads to the living room (off-limit). There are two door by the entrance one door leads to the daycare area and one door leads to the living room. LPA observed sofas, a coffee table, a dining table, and chairs in the living room. There is a fireplace in the living room which has been blocked off to prevent access. Next LPA toured the three off-limit bedrooms and one off-limit bathroom and did not observe any hazards. Next LPA toured the off-limit kitchen adjacent to the living room and off-limit laundry room adjacent to the kitchen and did not observe and hazards. There is a sliding glass door between the living room and daycare room, per applicant it will be kept closed all the time. Next LPA toured the daycare room and observed all electrical outlets were covered in the daycare room. LPA observed children table, chairs, changing table, toys in the daycare room. LPA observed safety latches on the kitchen cabinet in day area. Next LPA toured the one bathroom in day care area and observed a safety latch on the cabinet under the sink. Next LPA toured the backyard. There is a door in the daycare area which leads to the backyard. LPA observed a table, chairs, and kitchen area in the backyard. Next LPA toured the sideyard (grass area) adjacent to the living room, LPA asked applicant to add a gate by the rose bushes to make it safe for children and cover AC unit. Next LPA toured the side yard adjacent to the daycare area and asked applicant to add a gate by the stairs and cover AC unit.
LPA observed the required 2A 10 BC fire extinguisher was anchored to the wall in the daycare area by the entrance. Per applicant she purchased the fire extinguisher in 03/15/21 as read by LPA from the receipt. Applicant also tested the carbon monoxide and smoke detector in the daycare area. It sounded off the alarm and heard by LPA to be functional.

The applicant states at 11:32 a.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 10:30 a.m., there are no bodies of water or firearms on the premises. There is a small dog on the premises that will be kept in off-limits area.

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: 02/05/2021), Pediatric First Aid and CPR (ex. 01/2023).

REPORT CONTINUES ON NEXT PAGE 2 of 5

SUPERVISOR'S NAME: Christina Gabelman	TELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Anomeh Eivazian	TELEPHONE: (323) 981-3391
LICENSING EVALUATOR SIGNATURE:	DATE: 04/27/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/27/2021

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: VARDANIAN FAMILY CHILD CARE	FACILITY NUMBER: 198020781
	VISIT DATE: 04/27/2021

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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.
-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.

REPORT CONTINUES ON NEXT PAGE 3 of 5

SUPERVISOR'S NAME: Christina Gabelman	TELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Anomeh Eivazian	TELEPHONE: (323) 981-3391
LICENSING EVALUATOR SIGNATURE:	DATE: 04/27/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/27/2021

LIC809 (FAS) - (06/04)

Page: 3 of 5

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: VARDANIAN FAMILY CHILD CARE	FACILITY NUMBER: 198020781
	VISIT DATE: 04/27/2021

NARRATIVE

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Infant Care: Applicant states at 10:45 a.m. that she cares 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.

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 has proof of immunization against pertussis, measles, and influenza. Applicant completed required mandated reporter training on 02/15/2020. Mandated reporter training must be completed every 2 years. 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 inquired into the applicant’s practices related to COVID-19. Karine Vardanian applicant stated that they will practice hygiene such as hand washing with the children. Applicant has hand sanitizer available in the drop off area and inside the home. Karine Vardanain states they will practice social distancing with children, take children temperature daily, applicant and staff will wear masks all the times and will teach and encourage children 2 years and older about wearing proper face covering.

REPORT CONTINUES ON NEXT PAGE 4 of 5

SUPERVISOR'S NAME: Christina Gabelman	TELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Anomeh Eivazian	TELEPHONE: (323) 981-3391
LICENSING EVALUATOR SIGNATURE:	DATE: 04/27/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/27/2021

LIC809 (FAS) - (06/04)

Page: 4 of 5

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: VARDANIAN FAMILY CHILD CARE	FACILITY NUMBER: 198020781
	VISIT DATE: 04/27/2021

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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

The following corrections need to be corrected prior to obtaining a small family child care license. Corrections are due by 06/02/2021.
1. Applicant will cover two AC units in two side yards
2. Applicant will add a gate to the side yard adjacent to the living to make the rose bushes inaccessible to the children.
3. Applicant will add a gate to the side yard adjacent to the daycare room to make the stairs inaccessible to the children.
4. Applicant will add an additional lock and door alarm on the main entrance door to make it safe for children.

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 Karine Vardanian Applicant at 1:30 p.m. who is in agreement with the above.
REPORT END 5 of 5

SUPERVISOR'S NAME: Christina Gabelman	TELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Anomeh Eivazian	TELEPHONE: (323) 981-3391
LICENSING EVALUATOR SIGNATURE:	DATE: 04/27/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/27/2021

LIC809 (FAS) - (06/04)

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