364830460-12-11-2019-12-CC-JNEL-BJRQLW-20191211111636

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 364830460
Report Date: 12/11/2019
Date Signed: 12/11/2019 11:16:45 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1605 EAST PALMDALE BLV, STE A
PALMDALE, CA 93550

FACILITY NAME:	KRPEKYAN-ARABYAN FAMILY CHILD CARE HOME		FACILITY NUMBER:	364830460
ADMINISTRATOR:	KRPEKYAN-ARABYAN FLORA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(626) 375-6705
CITY:	VICTORVILLE	STATE: CA	ZIP CODE:	92392
CAPACITY:	14	CENSUS: 11	DATE:	12/11/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	09:15 AM
MET WITH:	Flora Krpekyan-Arabyan		TIME COMPLETED:	11:30 AM

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	Licensing Program Analyst (LPA) Neal met with licensee, Flora Krpekyan-Arabyan, for the purpose an Annual/Random inspection. Family members residing in the home are 2 adults (licensee and her husband) her infant child. This is a single story 4 bedroom, 2 bathroom home with kitchen, living room, dining room, family room and garage. The garage is used for storage and laundry only and no child care activities are conducted there. There is no pool, spa or other bodies of water on the premises. LPA observed 11 children, licensee and her assistant present during this inspection. Main care is provided in 2 of the bedrooms, which have been combined by taking out a portion of the wall. Children use the bathroom located in the hallway next to the child care room. Children have access to the family room, kitchen and backyard. Off limits areas include all the other bedrooms (safety knobs), 1 bathroom (in master bedroom), and the garage (key lock). Laundry is in the garage. The home was inspected inside and out for safety, comfort, cleanliness, telephone service, heating and ventilation, inaccessibility to poisons, detergents/cleaning compounds (laundry area), medicines, and hazardous items that can pose a danger to children. Sharp knives and medications are located in upper kitchen cabinets. Facility roster was observed complete and maintained. Fire/earthquake drills are current.

SUPERVISOR'S NAME: Mariela Ramon	TELEPHONE: (661) 789-6952
LICENSING EVALUATOR NAME: Jazelle Neal	TELEPHONE: (661) 568-8945
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)

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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, 1605 EAST PALMDALE BLV, STE A
PALMDALE, CA 93550

FACILITY NAME: KRPEKYAN-ARABYAN FAMILY CHILD CARE HOME	FACILITY NUMBER: 364830460
	VISIT DATE: 12/11/2019

NARRATIVE

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Children play in the backyard. There is a large anchored play structure with swings and a slide which is not being used at present and pending repair. LPA observed no pointed/sharp parts on the play structure. LPA also observed small, age appropriate play structures and other toys in good condition. There is 1 small dog.
Per licensee, there are no weapons or firearms of any kind in the facility. The LPA did not observe any weapons. LPA observed age appropriate toys and napping equipment on the premises. There are mats and pack and plays available for napping children. The required fire extinguisher, smoke detector and carbon monoxide detector are in operable condition. Fireplace is properly screened. Home has central AC and heat. CPR/First Aid for both Licensee and assistant expires 02/09/2021. Licensee has a First Aid kit. LPA observed the parent board and required documents are posted. Licensee and assistant have current Mandated Reporter certificates of completion on file (licensee's completed 11/28/2019). Licensee was reminded that Mandated Reporter training for child care must be completed every 2 years for licensee's and anyone assisting in child care.

The following was discussed with the licensee:
Mandatory Forms for the children’s files and provider’s files, Requirements for fire drills, earthquake drills and documentation for both. Role and responsibilities of being a mandated reporter were reviewed. Licensee reminded that 100% supervision is required at all times to children in care. The licensee was advised how to access forms and Regulations for Family Child Care online at www.ccld.ca.gov. Licensee was made aware that it is her responsibility to know the regulations as well as anyone who assists in providing care. Licensing must have the facility’s phone number at all times; if the phone number is changed, licensing must be notified. Regulation prohibits the smoking of tobacco in a private residence that is licensed as a family child care home and in those areas of the family child care home where children are present (24/7 ban). State law prohibits baby walkers, bouncy seats, exersaucers and any other items that fall into that category.

SUPERVISOR'S NAME: Mariela Ramon	TELEPHONE: (661) 789-6952
LICENSING EVALUATOR NAME: Jazelle Neal	TELEPHONE: (661) 568-8945
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1605 EAST PALMDALE BLV, STE A
PALMDALE, CA 93550

FACILITY NAME: KRPEKYAN-ARABYAN FAMILY CHILD CARE HOME	FACILITY NUMBER: 364830460
	VISIT DATE: 12/11/2019

NARRATIVE

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Requirements for fingerprint clearances and associations were discussed with the licensee. Licensee can be cited a civil penalty of $100 per day, up to $500.00 for the 1^st offense and up to $3000.00 for the 2^nd offense within a 12 month period, PER PERSON.

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

Licensee was reminded of the requirement to report unusual incidents and/or injuries to the parent/guardian and Licensing within the time frame specified by the regulation and on the form LIC624B. Handout on Safe Sleep concepts was given and discussed.

Licensee was advised that the Notice of Site Visit must be posted at the entrance of the facility for a period of 30 days. If a serious violation is cited, a copy of the licensing report (LIC809 or LIC9099) must also be posted for 30 days. If these requirements are not met, civil penalties in the amount of $100 per violation will be assessed. Copies of the reports must also be provided to each parent and a copy of the Acknowledgment of receipt of licensing report (LIC9224) must be kept in each child's file. In addition, any child enrolled within the following 12 months must also receive a copy of the Type A Citation.

No deficiencies were cited during this inspection.

Exit interview was conducted, report was read and a copy was provided to licensee on this date.

SUPERVISOR'S NAME: Mariela Ramon	TELEPHONE: (661) 789-6952
LICENSING EVALUATOR NAME: Jazelle Neal	TELEPHONE: (661) 568-8945
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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