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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364830460
Report Date: 04/19/2022
Date Signed: 04/19/2022 12:19:55 PM


Document Has Been Signed on 04/19/2022 12:19 PM - 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, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551



FACILITY NAME:KRPEKYAN-ARABYAN FAMILY CHILD CARE HOMEFACILITY NUMBER:
364830460
ADMINISTRATOR:KRPEKYAN-ARABYAN FLORAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(626) 375-6705
CITY:VICTORVILLESTATE: CAZIP CODE:
92392
CAPACITY:14CENSUS: 10DATE:
04/19/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:48 AM
MET WITH:Flora Krpekyan Arabyan licenseeTIME COMPLETED:
12:25 PM
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Licensing Program Analyst (LPAs) Steven Montoya conducted an unannounced Required 1 Year inspection at the above facility. Upon arrival, the LPA met licensee’s assistant Melissa Reyes, who guided the LPA to tour of the facility. Individuals reside in the home include 2 adults (licensee, her husband and daughter) and minor children. Per LIS, facility annual fees are current. All adults living in the home have been background cleared. Per licensee, the hours of operation are Monday through Friday 6:00 a.m to 6:00 p.m.

The Home is set up as follows:
This is a single story house with 4 bedrooms, 2 bathrooms, kitchen/dining room, family/daycare room, living room, and attached garage. Per Licensee the living room, and family room/kitchen, 1 bathroom are utilized for the family child care activity area. Per licensee off-limit areas of the home is the 3 bedrooms (master bathroom, daughter room, laundry room, and garage. The home was inspected for safety, comfort, cleanliness, telephone service, central air and heat and ventilation. The Licensee states the off-limit areas of the home are the master and across day care room and laundry room and garage. .

Main Area: Main care will be conducted in the living room. Family room/ Daycare area: In the Family room which is the designated playroom, LPA observed age-appropriate toys and furniture for the children. Several plastic storage bins for cubbies stored in the living room closet. There are games and books on the premises of this facility. The mats were observed to be in good condition. The home has central heating and air conditioning.
SUPERVISOR'S NAME: Claretta YatesTELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Steven MontoyaTELEPHONE: (661) 202-4701
LICENSING EVALUATOR SIGNATURE:
DATE: 04/19/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/19/2022
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, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: KRPEKYAN-ARABYAN FAMILY CHILD CARE HOME
FACILITY NUMBER: 364830460
VISIT DATE: 04/19/2022
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Facility Roster: LPA observed Child Care Facility Roster and LIS Facility Roster which the licensee reviewed. Per Licensing Information System, facility annual fees were current. Licensee has posted as required the Facility License, Emergency Disaster plan, and Parents Rights Poster.

The following information was discussed with the licensee:
ü Mandatory Forms for the children’s files and provider’s files.
ü Requirements for fire drills, earthquake drills, and documentation for both.
ü The role and responsibilities of being a mandated reporter were discussed.
ü The licensee is reminded that 100% supervision is required for children at all
times.

Capacity requirements, Roster requirements, Posting requirements, Documentation requirements for disaster drills (fire and earthquake). ·Mandated Reporter Training: The licensee has completed the online mandated reporter training at www.mandatedreporterca.com, and need to renew by 11/29/2021Mandatory Forms for the children’s files and provider’s files, and Safe Sleep Awareness. The role and responsibilities of being a mandated reporter were reviewed. The licensee was reminded that supervision is always required for children in care.

Licensee was made aware it is their responsibility to know the regulations as well as anyone who assists in providing care. Licensee was advised inaccessibility of hazards must be constantly reassessed depending on the children in care. Licensing must always have the facility’s phone number; if the phone number is changed, licensing must be notified.


Licensee was advised 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. The licensee was informed of the responsibility to report suspected Child Abuse by calling the Child Abuse Hot-line at 1-800-540-4000. Also call the CCL office and follow up with a written Unusual Incident/Injury Report (LIC 624B).
SUPERVISOR'S NAME: Claretta YatesTELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Steven MontoyaTELEPHONE: (661) 202-4701
LICENSING EVALUATOR SIGNATURE:

DATE: 04/19/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/19/2022
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, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: KRPEKYAN-ARABYAN FAMILY CHILD CARE HOME
FACILITY NUMBER: 364830460
VISIT DATE: 04/19/2022
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Family Room: In the family room a fireplace was observed was properly screened via mirror glass doors and is inaccessible to children. In the family room, there were additional toys observed to be in the room stored on cubbies. Napping: Children will nap in the designated nap areas with adult supervision. Licensee stores napping equipment in the bedroom near the front door entrance. Per licensee children nap in the living room. There are many toys, pillows and blanket. LPAs discussed Safe Baby Sleep with the Licensee’s daughter.

Kitchen The kitchen was inspected to ensure hazardous and dangerous items were inaccessible to children (Safety latches). LPAs inspected the kitchen and observed all lower cabinets and drawer have child proof latches in good condition.

Bathroom #1: Children utilize a bathroom is in the hallway. Bathrooms were toured, and inspected sink/toilet are in operable condition. Toilet and faucets are clean, safe, and operable. All poison and medications are made inaccessible to children with child safety latches on the sink cabinet. There was one cabinet that was observed to have a child proof latch on it; hand soap was observed in the cabinet.

Backyard: The backyard was inspected; the backyard is concrete and dirt landscaping surrounded by wood and vinyl fencing. Children have access to the backyard. LPA observed, a plastic kid's play house and other age appropriate toys. LPAs did not observe a swimming pool or bodies of water on the premises. LPAs also observed a 3 small playhouse. Licensee will ensure the children are always supervised while outside in the backyard.

Others:

AC/Heating Unit was observed. AC/Heating Unit is located on the right side of the home it accessible to children via barrels blocking access the unit. The First Aid kit is located in the Master Bedroom inaccessible to children. The First Aid Kit was observed complete with supplies and a first aid manual.
SUPERVISOR'S NAME: Claretta YatesTELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Steven MontoyaTELEPHONE: (661) 202-4701
LICENSING EVALUATOR SIGNATURE:

DATE: 04/19/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/19/2022
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, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: KRPEKYAN-ARABYAN FAMILY CHILD CARE HOME
FACILITY NUMBER: 364830460
VISIT DATE: 04/19/2022
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Fire extinguisher (2A10BC): LPA observed there is a required fire extinguisher (3A40BC) few years back and located in the kitchen inaccessible to children. Fire Drill and Disaster Drill: Per the licensee, fire and disaster drills are conducted every 6 months. Smoke Detectors and Carbon Monoxide: The smoke detectors and carbon monoxide devices tested operable.

Electrical outlets: All unused electrical outlets are plugged in and made inaccessible to children.
Bodies of water: There are no bodies of water in the home. Medications and cleaning solutions are stored in locked cabinets in the off-limits area (Master Bedroom). Weapons or Firearms: Per licensee, there are no weapons or firearms. LPA did not observe any weapons or firearms.

Incidental Medical Services (IMS): 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. The Licensee will providing medication to children.
Documentation: with permission documented.

· CPR/First Aid: LPA observed licensee has current Pediatric CPR and First Aid Training with expiration date (04/2023) 1 hour of nutrition training, (8) hours of Preventive Health and Safety Training. Immunization: The licensee has the required immunization. The licensee provided a written statement declining the influenza vaccination.

Transportation: The licensee does not provide transportation for children.
2 Staff Files: Assistant Melissa is considered lead teacher.
SUPERVISOR'S NAME: Claretta YatesTELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Steven MontoyaTELEPHONE: (661) 202-4701
LICENSING EVALUATOR SIGNATURE:

DATE: 04/19/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/19/2022
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, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: KRPEKYAN-ARABYAN FAMILY CHILD CARE HOME
FACILITY NUMBER: 364830460
VISIT DATE: 04/19/2022
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Safe Sleep: LPA discussed the safe sleep regulations with licensee [or facility representative and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA informed licensee [facility representative] 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.

The regulation prohibits the smoking of tobacco in a private residence that is licensed as a family childcare home and in those areas of the family day 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.

Licensee was advised to visit the CCL website (www.ccld.ca.gov) to obtain updates of courses and updates/changes to the regulations.


n Our Quarterly updates come out every 3 months they are also now in Spanish please log in to the CCLD website or you can email our advocates to have the quarterly updates send directly to your email. Child Care Advocates information: www.childcareadvocatesprogram@cdss.ca.gov

ü Notice of Site Visit: A notice of site visit was given and must remain posted for 30 days. No deficiency or citations given and notice of appeal rights provided to licensee. .

SUPERVISOR'S NAME: Claretta YatesTELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Steven MontoyaTELEPHONE: (661) 202-4701
LICENSING EVALUATOR SIGNATURE:

DATE: 04/19/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/19/2022
LIC809 (FAS) - (06/04)
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