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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343621688
Report Date: 06/17/2022
Date Signed: 06/17/2022 10:51:28 AM


Document Has Been Signed on 06/17/2022 10:51 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833



FACILITY NAME:VARDANYAN, MARIAMFACILITY NUMBER:
343621688
ADMINISTRATOR:VARDANYAN, MARIAMFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(702) 703-9002
CITY:RANCHO CORDOVASTATE: CAZIP CODE:
95670
CAPACITY:14CENSUS: 0DATE:
06/17/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Mariam Vardanyan - LicenseeTIME COMPLETED:
11:00 AM
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Licensing Program Analysts (LPA) Katrina Owens met with licensee, Mariam Vardanyan and her husband Vladimir Vardanyan for a Change of location inspection.

A tour of the home, inside and outside, as shown on the facility sketch is conducted. . There are no "bodies of water" at this home. Licensee states there are no weapons or firearms in the home. LPA observed poisons, cleaning compound's, medications and other hazardous items are inaccessible to children. There is no fireplace. Fire extinguisher, Carbon Monoxide Detector and Smoke Detector meets regulations. There are no pets observed today. There are no stairs in the home. Toys and play equipment that were observed appear to be safe. There is a working telephone. She understand children are to be supervised when outside in any unfenced play area. LPA discussed sleeping plan for each infant under 12 months old. LPA discussed 15 minute check log document with licensee. LPA discussed and gave licensee a forms packet at time of inspection.

LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep web page at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/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 https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

Staff-child ratios were discussed. All adults who reside or work in the home have a criminal record clearance or exemption. There are no excluded individuals present at this home. Licensee, Mariam Vardanyan 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. Continued on next page.

SUPERVISOR'S NAME: Keven PetersTELEPHONE: (916) 263-5728
LICENSING EVALUATOR NAME: Katrina OwensTELEPHONE: 916-263-6280
LICENSING EVALUATOR SIGNATURE:
DATE: 06/17/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/17/2022
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, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833
FACILITY NAME: VARDANYAN, MARIAM
FACILITY NUMBER: 343621688
VISIT DATE: 06/17/2022
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Pediatric CPR/FA is current with expiration date of 12/2022. A child roster is maintained. Fire and disaster drills are conducted every six months and documented.

LPA observed proof that licensee and staff/ volunteers have met the requirements of SB 792.

LPA observed that all staff has completed the required mandated reporter training (AB 1207) at website: www.mandatedreporterca.com. LPA discussed the Effects of Lead Exposure brochure.

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



Off-limit rooms are: the entire front of the house. Licensee acknowledges that children may never enter these off-limit areas. During the exit interview, LPA discussed AB 633, Parent Notification Requirements, and the posting of licensing inspection notices and reports. Hours of operation are 6:00 AM to 6:00 PM; Monday thru Friday and other hours as arranged. Licensee states she does transport children.

LPA provided the Community Care Licensing website www.ccld.ca.gov, so the licensee can obtain updated licensing information, new regulations and access forms. LPA advised licensee of their responsibility to stay current in regards to new regulations. LPA also included the email address for the children's advocacy program to stay current on new laws childcareadvocatesprogram@dss.ca.gov.

Effective today 6/17/2022 applicant is a license to serve up to either 14 children, (WHEN THERE IS AN ASSISTANT PRESENT), 12 children -No more than 4 infants. Capacity 14 - No more than 3 infants. 1 Child in Kindergarten or Elementary school and 1 child at least age 6.
SUPERVISOR'S NAME: Keven PetersTELEPHONE: (916) 263-5728
LICENSING EVALUATOR NAME: Katrina OwensTELEPHONE: 916-263-6280
LICENSING EVALUATOR SIGNATURE:

DATE: 06/17/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/17/2022
LIC809 (FAS) - (06/04)
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