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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 300606420
Report Date: 12/11/2019
Date Signed: 12/11/2019 04:24:25 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME:ARI GUIRAGOS MINASSIAN ARMENIAN SCHOOLFACILITY NUMBER:
300606420
ADMINISTRATOR:WARTAN, TALINFACILITY TYPE:
850
ADDRESS:5315 W. MC FADDEN AVETELEPHONE:
(714) 839-7831
CITY:SANTA ANASTATE: CAZIP CODE:
92704
CAPACITY:55CENSUS: 37DATE:
12/11/2019
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
02:30 PM
MET WITH:Administrator Talin Wartan TIME COMPLETED:
05:00 PM
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Licensing Program Manager (LPM) Thuy Ho and Licensing Program Analyst (LPA) Ketki Desai conducted an unannounced Case Management - other inspection today at the facility to measure the four classrooms
(Room # 1, # 2, # 3 and #5).
Census in each of the four classroom identified were within the approved capacity.
Room # 1: 7 children with one staff / Room # 2: 8 children with one staff / Room # 3 : 16 children with 2 staff and Room # 5 : 7 children with one staff
Per the past facility sketch submitted and approved by CCL and Fire clearance dated 12-18-18, there had been some changes in the room configuration. The changes initiated by the facility were as follows, Room # 6 is now under the Elementary section and Room # 4 now also under Elementary section and during the past inspection Room # 3 & 4 (Corner big room was addressed together) and now is identified as Room # 3 by itself.

LPM (THuy Ho) and LPA (Ketki Desai) measured the four classrooms and the measurements are as follows:
Indoor space:
Room # 5 = 20'3 x 19'9 = 399.9' divided by 35' = 11 children
Room #3 = 16'3 x 21'6 = 349'
10'6 x 21'6 = 225.75
Triangle shape of 21'6 x6'6 = 139'/2 = 70'
Total for room 3: 349' + 225.75 + 70' = 644523'/35' = 18 children
Room 2 = 19'9 x 20'9 = 409'/35' = 12 children.
Room 1 = 19'9 x 19'6 = 385'/35' = 11 children.
Total indoor space: 11 + 18 + 12 + 11 = 52 children.

Toilets: 4 X 15 = 60 children.
Sinks: 4 X 15 = 60 children.
SUPERVISOR'S NAME: Patricia MaganaTELEPHONE: (714) 703-2821
LICENSING EVALUATOR NAME: Ketki DesaiTELEPHONE: (714) 743-8635
LICENSING EVALUATOR SIGNATURE:

DATE: 12/11/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/11/2019
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 2
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME: ARI GUIRAGOS MINASSIAN ARMENIAN SCHOOL
FACILITY NUMBER: 300606420
VISIT DATE: 12/11/2019
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Outdoor space (Previously measured on 5/10/18) 3375' divided by 75' = 45 children.
A waiver to use staggered schedules for outside time will be submitted.

Based on today's measurements, facility only has sufficient activity space to support the capacity of 52 children.

After a tour of the center, no deficiency was observed.


The facility representative was informed that the CRIMINAL RECORD STATEMENT (LIC 508) has been updated, and the facility must now use the new form with revised date 7/15. The facility representative was also informed that the LIC 508 must be submitted with all Criminal Background Clearance Transfer Request (LIC9182).

The facility representative was informed that Licensing Quarterly Updates are available at www.ccld.ca.gov

Information on the additional nutrition training, immunization requirements for children, and Health Schools Act (http://www.cdpr.ca.gov/docs/pestmgt/schoolipm.htm) were provided. The facility representative was informed, and website given, about the California Child Care Disaster Plan has been posted to the UCSF California Childcare Health Program website: cchp.ucsf.edu/content/disaster-preparedness.

Also provided was information about the E-Learning Modules available at https://ccld.childcarevideos.org.

Exit interview conducted. Notice of Site Visit was posted. Facility representative was informed that the Notice of Site Visit must be posted for 30 consecutive days. Failure to post it will result in civil penalties of $100.

LPA received the following from the Licensee: Updated LIC 200(A) reflecting the change in capacity and a Check for 25$ payable to CDSS, for change in capacity.
SUPERVISOR'S NAME: Patricia MaganaTELEPHONE: (714) 703-2821
LICENSING EVALUATOR NAME: Ketki DesaiTELEPHONE: (714) 743-8635
LICENSING EVALUATOR SIGNATURE:

DATE: 12/11/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/11/2019
LIC809 (FAS) - (06/04)
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