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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376100143
Report Date: 09/26/2019
Date Signed: 10/01/2019 01:41:02 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME:BAGIRYAN, IRINA FAMILY CHILD CAREFACILITY NUMBER:
376100143
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 0DATE:
09/26/2019
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
12:54 PM
MET WITH:Irina Bagiryan TIME COMPLETED:
03:10 PM
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THIS IS AN ELECTRONIC VERSION OF AN ORIGINAL HAND WRITTEN REPORT THAT WAS COMPLETED AND SIGNED BY APPLICANT AND THE DEPARTMENT ON 09/26/19.

Licensing Program Analysts (LPAs) Rajani Goudreau and Martha Malane conducted an announced Pre-Licensing inspection for a change of location. Upon arrival, LPAs met with applicant Irina Bagiryan. Also, present in the home licensees’ husband. Business hours are: Monday through Friday from Monday through Friday 7:30 a.m. to 5:30 p.m. This one story, 3 bedroom and 3 bathroom home was toured and inspected to ensure an environment safe for the care and supervision of children.

All cleaning compounds, detergents, medications and other items which couple pose a danger to children are stored where they are inaccessible to children and poisons are to be locked away. The fire extinguisher, smoke and carbon monoxide detector meet requirements and are operational. Children’s toys and play equipment are safe and age appropriate. There are no bodies of water observed by LPA during inspection. There are no firearms or other weapons in the home, per applicant. Pediatric CPR and First Aid certifications expire on Aug 2020. Preventative Health Practices course completed, certificate on file. Fireplaces located in family and on patio in the back yard is screened and not in use. Primary telephone is a cell which is operational. A review of staff records on this date indicates all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse clearances or exemptions. Applicants owns the facility and has provided proof of control of property by a grant deed. Applicant states they are financially secure to operate a family child care home and will comply with all regulations and laws governing family child care homes. Applicant has met immunization requirement per SB792 and completed the AB1207 Mandated Reported Training.
SUPERVISOR'S NAME: Jason GarayTELEPHONE: (619) 767-2250
LICENSING EVALUATOR NAME: Rajani GoudreauTELEPHONE: (619) 767-2215
LICENSING EVALUATOR SIGNATURE:

DATE: 09/26/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/26/2019
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 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME: BAGIRYAN, IRINA FAMILY CHILD CARE
FACILITY NUMBER: 376100143
VISIT DATE: 09/26/2019
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The following correction is needed prior to issuance of the license:
  • Make thorn bushes in patio/back yard inaccessible.

Once the corrections are made, proof of corrections are to be submitted to Licensing no later than 10/04/19. Once the correction is received the facility will be licensed after final file review. After final file review, License will be mailed to applicant. LPA informed applicant upon receipt of the license, the license shall be posted in a prominent place.
SUPERVISOR'S NAME: Jason GarayTELEPHONE: (619) 767-2250
LICENSING EVALUATOR NAME: Rajani GoudreauTELEPHONE: (619) 767-2215
LICENSING EVALUATOR SIGNATURE:

DATE: 09/26/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/26/2019
LIC809 (FAS) - (06/04)
Page: 3 of 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME: BAGIRYAN, IRINA FAMILY CHILD CARE
FACILITY NUMBER: 376100143
VISIT DATE: 09/26/2019
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Applicant will use the following ares for child care: family room dining room, dining area, bathroom located near front door of home and patio/back yard. Off limits areas of the home include: two bedrooms, bathroom located near bedrooms of home, master bedroom, master bathroom and guest house located in back yard of home. Off limit areas of the home are made securely inaccessible. Patio and partial of back yard is fenced. However, there is a non-fenced yard on the other side of fence in which is off limits.

LPA discussed and provided applicant/or Licensee with the following: information on SIDS, shaken baby syndrome, lead poisoning effects brochure, Heart and Nutrition Months hand out, insurance, child abuse reporting, mandated reporter requirements, community resources, children’s records/facility records/required postings-LIC911D, immunization requirements, unusual incident report-LIC624B, roster requirements-LIC9040, visual for ratio/capacity, prohibited items handout (walkers, exersaucers, jumpers and bouncy seats), emergency drill log example, and the YMCA Resource Center.

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 provided 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. LPA discussed California Megan's Law and provided Applicant with the following website: www.meganslaw.ca.gov. LPA informed applicant in order to access CCLD-Childcare regulations, quarterly updates, licensing forms, pay annual fee to visit the following website: http://ccld.ca.gov. LPA and Licensee discussed California Megan's Law and LPA provided: www.meganslaw.ca.gov. To access Child Care Licensing Regulations and Forms visit the following website: http://ccld.ca.gov. LPA discussed and provided applicant/licensee with the following: Child Care Advocates - (916) 654-1541 and email address childcareadvocatesprogram@dss.ca.gov.In addition, for common questions or questions regarding licensing requirements to contact the Child Care Licensing duty line at 619-767-2248. LPA discussed the following with applicant or Licensee: maximum capacity for a small family child care home: 4 infants only (infants mean any children under 24 months); or 6 children with no more than 3 infants; or (with landlord consent) 8 children with no more than 2 infants, 1 child in kindergarten or elementary school and 1 child at least age 6 including children under age 10 who live in the licensee's home.
SUPERVISOR'S NAME: Jason GarayTELEPHONE: (619) 767-2250
LICENSING EVALUATOR NAME: Rajani GoudreauTELEPHONE: (619) 767-2215
LICENSING EVALUATOR SIGNATURE:

DATE: 09/26/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/26/2019
LIC809 (FAS) - (06/04)
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