<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376700784
Report Date: 10/15/2019
Date Signed: 10/15/2019 01:55:32 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:GROW SMART CHILDREN'S ACADEMY -SPRING VALLEYFACILITY NUMBER:
376700784
ADMINISTRATOR:MOHAMMAD, NESRINFACILITY TYPE:
850
ADDRESS:8735 JAMACHA BLVDTELEPHONE:
(619) 479-7577
CITY:SPRING VALLEYSTATE: CAZIP CODE:
91977
CAPACITY:43CENSUS: 20DATE:
10/15/2019
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:Armen ArshakianTIME COMPLETED:
02:15 PM
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’s (LPAs) Samantha Salunga and Keturah Lane completed an unannounced case management (non-compliance) inspection. Upon arrival, LPA's met with Director, Nesrin Mohammad. Armen Arshakian (Facility Administrator) and Hunan Arshakian (CEO), arrived soon after to conclude inspection. LPA's observed a total of 22 children present with a total of three staff members.

During inspection of Room #2, LPA's observed a total of 9 toddlers and two school-age children with staff members, Naisan Mohammad and Angelica Diaz. The two school-age children were Naisan's own children who happened to be at the facility due to family emergency. This facility is not licensed for school-age children. Furniture and age appropriate equipment is in good condition indoors and outdoors. Facility has two children's restrooms located in Room 1 and 2. Mr. Arshakian states that the staff utilize the restrooms located in the Community Center (building adjacent from this facility). Mr. Arshakian provided LPA's with an updated facility sketch showing location of staff restroom. LPA's observed the rooms to be safe and clean. Drinking water is readily accessible inside and outside the classroom. All disinfectants, cleaning solutions, and other hazardous items are inaccessible to children through latches and locks. Outdoor play area is fenced with adequate material for cushioning. Area has canopies/trees used for shade. There are no bodies of water or weapons at this facility. No excluded individuals are present. Last fire drill was conducted and documented on 07/02/2019. Pediatric First Aid/CPR reviewed and in compliance. Sign in/sign out sheets are well maintained. Admission Agreement forms reviewed for some children. Staff records contain documentation of education, training, and/or experience. Mandated Child Abuse Reporting-per AB1207 was reviewed and is in compliance. Immunization records per SB792 was reviewed and in compliance.
SUPERVISOR'S NAME: Monica CuddyTELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Samantha SalungaTELEPHONE: (619) 767-2209
LICENSING EVALUATOR SIGNATURE:

DATE: 10/15/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/15/2019
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: GROW SMART CHILDREN'S ACADEMY -SPRING VALLEY
FACILITY NUMBER: 376700784
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/15/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
10/15/2019
Section Cited

1
2
3
4
5
6
7
Limitations on Capacity. A licensee shall not operate a child care center beyond the conditions and limitations specified on the license, including the capacity limitation. This was not met as evidenced by; LPA's observed a
8
9
10
11
12
13
14
total of 9 toddlers and two school-age children in Room #2. This facility does not have a school age license. The two school age children were observed sitting quietly in the corner of the classroom on their telephones. This poses a Potential Health and Safety risk to the clients in care.
8
9
10
11
12
13
14

1
2
3
4
5
6
7

1
2
3
4
5
6
7
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Monica CuddyTELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Samantha SalungaTELEPHONE: (619) 767-2209
LICENSING EVALUATOR SIGNATURE:
DATE: 10/15/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/15/2019
LIC809 (FAS) - (06/04)
Page: 2 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: GROW SMART CHILDREN'S ACADEMY -SPRING VALLEY
FACILITY NUMBER: 376700784
VISIT DATE: 10/15/2019
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
26
27
28
29
30
31
32
Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, an updated Plan of Operation that includes 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

To access our Regulation and Forms please use our WEBSITE: http://ccld.ca.gov


See 809D for cited deficiency. NOTICE OF SITE VISIT IS TO BE POSTED FOR 30 DAYS. LPA's observed Mr. Arshakian post notice of site visit. Mr. Arshakian was provided a copy of the facility's appeal rights (LIC 9058 01/16) and his signature on this form acknowledges receipt of these rights.
SUPERVISOR'S NAME: Monica CuddyTELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Samantha SalungaTELEPHONE: (619) 767-2209
LICENSING EVALUATOR SIGNATURE:

DATE: 10/15/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/15/2019
LIC809 (FAS) - (06/04)
Page: 3 of 3