384001557-2-4-2020-05-CC-BVAN-BLH2BL-20200204161517

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 384001557
Report Date: 02/04/2020
Date Signed: 02/04/2020 04:15:31 PM

COMPREHENSIVE INSPECTION

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME:	MELIKYAN, GAYANE & GAZANYAN, OGANES		FACILITY NUMBER:	384001557
ADMINISTRATOR:	MELIKYAN, GAYANE		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(415) 672-4935
CITY:	SAN FRANCISCO	STATE: CA	ZIP CODE:	94116
CAPACITY:	14	CENSUS: 6	DATE:	02/04/2020
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	02:15 PM
MET WITH:	Gayane Melikyan		TIME COMPLETED:	04:30 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 (LPA) Van met with the licensee, Gayane Melikyan, for an unannounced annual inspection. The purpose of the inspection was explained and was granted entry to the home by the licensee. Present today is six pre-school ages children with the licensee and a helper. The licensee is operating within capacity requirements on this day. All adults living or working in the home have criminal record clearances on file with the department. Daycare area is on the ground level including, the playroom, nap room, bathroom, and the backyard. The entire second floor and the garage on the ground floor are off-limit to children. Per licensee, sick children will be separated from the group and will be waited by one of the corners of the playroom for the parent to pick up. Along with the licensee, LPA inspected the daycare areas for health and safety hazards. During the inspection, LPA observed the following: The daycare area is clean, orderly, and equipped with age-appropriate toys and equipment for the children. The home has adequate lighting and ventilation. Home has a working telephone, working smoke and carbon monoxide detector, and a fully charged fire extinguisher. First aid supplies are available for children. The licensee stated there are no firearms or weapons in the home. Per licensee, there is a cat in the home, which is situated in the off-limit area on the second floor. LPA observed no pools, spas, or other bodies of water on the premises. There is an adequate supply of toys and other learning equipment for the children. Furniture, including pack-n-play, highchairs and chairs, are in good condition. Cots are provided to older children for napping. LPA did not observe any walkers, bouncers or any similar items. Licensee understands that smoking is prohibited in family childcare homes. LPA observed licensee had posted all the required forms (i.e., License, Notification of Parent's Rights, Notification of Personal Rights, and Emergency Disaster Plan). Per licensee, fire drills are conducted every six months, and a record of the drill was documented accordingly, and the last fire drill was performed on 10/30/2019.

SUPERVISOR'S NAME: Garfield Leung	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Brendon Van	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 02/04/2020

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/04/2020

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, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: MELIKYAN, GAYANE & GAZANYAN, OGANES	FACILITY NUMBER: 384001557
	VISIT DATE: 02/04/2020

NARRATIVE

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At 3:00 pm, LPA reviewed the children's records, licensee's records, and helper's records. LPA observed that the licensee maintained records of each child accordingly; identification and emergency information, consent for medical treatment, and parent’s rights are appropriately completed. The licensee and helper have a record of immunization and certificates of completion of mandated reporter training. The licensee and helper have valid Pediatric FirstAid and CPR training. LPA reviewed supervision and capacity requirements/expectations. The licensee states that she does not transport children but understands never to leave children unattended in vehicles. The licensee states she understands her capacity options. LPA also reviewed safe sleep for infants and provided informational handouts.

Licensee is aware that as of September 1, 2016, a person may not be employed or volunteer at a childcare facility unless he or she has been immunized against influenza, pertussis, and measles or qualifies for an exemption pursuant to Health and Safety Code 1597.662.

LPA reviews AB 1207 with the licensee. As of January 1, 2018, all staff is required to complete Mandated Reporter Training every two years. The training can be obtained online at www.mandatedreporterca.com.

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

See 809D for a deficiency that was cited in today’s inspection. A copy of this report was reviewed and provided to the licensee. This report will be kept in the facility file and will be made available for public review upon request. Notice of Site Visit was observed to be posted and shall remain posted for 30 days

SUPERVISOR'S NAME: Garfield Leung	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Brendon Van	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 02/04/2020

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/04/2020

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, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: MELIKYAN, GAYANE & GAZANYAN, OGANES	FACILITY NUMBER: 384001557
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 02/04/2020

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 02/19/2020 Section Cited	1 2 3 4 5 6 7	1596.954 Carbon monoxide detectors required; inspection. Every licensed child day care center shall have one or more carbon monoxide detectors in the facility that meet the standards established in Chapter 8 (commencing with Section 13260) of Part 2 of Division 12. The department shall account for the presence of these detectors during inspections.
	8 9 10 11 12 13 14	This requirement is not met as evidenced by; Based on observation LPA did not observe any carbon monoxide detector in the home. Not having a carbon monoxide detector in the building could pose a potential health and safe risks to children 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: Garfield Leung	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Brendon Van	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 02/04/2020

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/04/2020

LIC809 (FAS) - (06/04)

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