103911064-10-9-2023-04-CC-MHEA-CWFRVN-20231009132148

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 103911064
Report Date: 10/09/2023
Date Signed: 10/09/2023 01:21:53 PM

Document Has Been Signed on 10/09/2023 01:21 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
FRESNO CC RO, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME:	GEVORGYAN, NELLI FAMILY CHILD CARE		FACILITY NUMBER:	103911064
ADMINISTRATOR:	GEVORGYAN, NELLI		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(818) 292-5351
CITY:	FRESNO	STATE: CA	ZIP CODE:	93704
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 12	CENSUS: 6	DATE:	10/09/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	08:20 AM
MET WITH:	Nelli Gevorgyan		TIME COMPLETED:	12:20 PM

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On 10/09/2023, Licensing Program Analyst (LPA) Miguel Herrera, conducted an unannounced Annual Required Inspection and was met by Licensee, Nelli Gevorgyan. Also present was Staff #1. Days and hours of operation are Monday – Friday, from 6:00 AM to 6:00 PM.

LPA toured the home inside and outside, and a census was taken. Current facility sketch was reviewed, and Licensee confirmed that the living room, kitchen, dining room, bedroom #1 and bathroom are used for providing care and are accessible to children. All other rooms are off-limits and made inaccessible by use of doorknob spinners. There is no swimming pool or other bodies of water on the premises. Firearms and ammunition are stored and locked separately. No poisons were observed during the inspection. Detergents, cleaning compounds, medication and other hazardous items are inaccessible. There is no fireplace in the home. There is a working fire extinguisher, smoke detector, carbon monoxide detector and adequate heating and ventilation for safety and comfort. LPA was unable to observe the most current fire drill documentation with the date, time and how many children present. Licensee states she conducts fire drills every month per fire marshal recommendations but must have forgotten to document the fire drills. Licensee has a current roster of the children. There are no stairs in the home. Safe toys and play equipment are observed. The home has working telephone service and LPA confirmed the phone number is (818) 292-5351.

The outdoor play area in the backyard is fenced and there are no hazards to children present. Capacity as specified on the license is being maintained. LPA reviewed a sample of children’s files and observed files were complete with emergency information as required. LPA Herrera observed incomplete immunization records for child #4 as child #4 did not have MMR immunizations documented. Licensee’s Mandated Reporter Training was completed on 05/16/2023. Licensee’s pediatric CPR/First Aid certification expires on 08/2025. A review of records indicates that staff #1 has immunization records on file for influenza, pertussis, and measles. Assistant's Mandated Reporter Training was completed on 07/18/2023. Assistant's pediatric CPR/First Aid certification expires on 08/2025.

To be continued 809-C.

SUPERVISORS NAME: Juvenal Moctezuma
LICENSING EVALUATOR NAME: Miguel Herrera
LICENSING EVALUATOR SIGNATURE:	DATE: 10/09/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/09/2023

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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Document Has Been Signed on 10/09/2023 01:21 PM - It Cannot Be Edited

Created By: Miguel Herrera On 10/09/2023 at 10:34 AM

Link to Parent Document Below:

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: GEVORGYAN, NELLI FAMILY CHILD CARE	FACILITY NUMBER: 103911064
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 10/09/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

102425(j)(1)

Infant Safe Sleep

The provider shall supervise infants while they are sleeping and adhere to the following requirements: The provider shall physically check on the infant every 15 minutes. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on interview and record review, the licensee did not comply with the section cited above. Licensee did not provided proof of physically checking on infants every fifteen minutes and documenting any sign of distress, which includes but is not limited to flushed skin color, increase in body temperature, restlessness, and labored breathing on a sleeping log which poses an immediate health, safety, or personal rights risk to persons in care.
	POC Due Date: 10/23/2023
	Plan of Correction
1 2 3 4	Licensee will check on sleeping infants and document 15-minuted safe sleep logs. Licensee will submit two weeks of 15-minute safe sleep logs to Fresno Community Care Licensing Office by 10/23/2023.

Type B

Section Cited

HSC

1596.871(c)(1)(A)

Administration of Child Day Care Licensing

Subsequent to initial licensure, a person specified in subdivision (b) who is not exempt from fingerprinting shall obtain either a criminal record clearance or an exemption from disqualification, pursuant to subdivision (f) of this section or Section 1522.7, from the State Department of Social Services prior to employment, residence, or initial presence in the facility. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensee did not comply with the section cited above. Licensee states staff #1 was previously employed at a private preschool and just started working for licensee on 10/02/2023. However, staff #1 did not complete fingerprinting for a criminal record clearance or an exemption before she began working for licensee's daycare which poses an immediate health, safety, or personal rights risk to persons in care.
	POC Due Date: 10/23/2023
	Plan of Correction
1 2 3 4	Licensee immediately completed LIC 9182 transfer request and submitted the form to LPA Herrera.

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:

Juvenal Moctezuma

LICENSING EVALUATOR NAME:

Miguel Herrera

LICENSING EVALUATOR SIGNATURE:

DATE: 10/09/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/09/2023

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
FRESNO CC RO, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: GEVORGYAN, NELLI FAMILY CHILD CARE	FACILITY NUMBER: 103911064
	VISIT DATE: 10/09/2023

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Licensee states staff #1 was previously employed at a private preschool and just started working for her on 10/02/2023. LPA Herrera reminded licensee that all staff/volunteers must complete fingerprinting for a criminal record clearance or an exemption before they start working/volunteering at the daycare. Licensee understands and will immediately complete LIC 9182 transfer request.

Licensee has 2 infants enrolled in the facility. Licensee understands that there shall be one play yard for each infant in care, the play yard is kept free from all loose articles and objects while infants are sleeping, and there are no objects hanging above or attached to the play yard. Infants are not swaddled while in care. Licensing states she is transitioning the two infants (21 and 23 month olds) into sleeping mats as they are getting old enough to sleep in mats. Licensee did not provided proof of physically checking on infants every fifteen minutes and documenting any sign of distress, which includes but is not limited to flushed skin color, increase in body temperature, restlessness, and labored breathing on a sleeping log. LPA Herrera discussed safe sleep regulations with licensee and emphasized that infants up 24 months should have a 15-minute log on file. Licensee misunderstood the regulation and believed it was children up 12 months that needed to have a 15-minute sleeping log on file. Licensee states she now understands the safe sleep regulations regarding the 15-minute sleeping logs and will document safe sleep every 15 minutes for infants up to 24 months. Licensee states that infants can be visually observed through an open door if sleeping in a separate room.

Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

LPA discussed safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep as an additional resource. LPA also informed licensee [or 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.

To be continued on 809-C.

SUPERVISORS NAME: Juvenal Moctezuma
LICENSING EVALUATOR NAME: Miguel Herrera
LICENSING EVALUATOR SIGNATURE:	DATE: 10/09/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/09/2023

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
FRESNO CC RO, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: GEVORGYAN, NELLI FAMILY CHILD CARE	FACILITY NUMBER: 103911064
	VISIT DATE: 10/09/2023

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Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02- CCP. 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: https://www.ada.gov/resources/child-care-centers/.

Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain childcare by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California.

To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

Exit interview conducted and report was reviewed with licensee Nelli Gevorgyan. During the exit interview, the licensee confirmed that there are no Registered Sex Offenders living in the facility and LPA verified the RSO profile in FAS.

Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, the following deficiencies are being cited: (see LIC 809-D).

Licensee Nelly Gevorgyan was provided appeal rights.

This report shall be made available to the public upon request. LIC 9213 Notice of Site Visit is provided and required to be posted for 30 days.

SUPERVISORS NAME: Juvenal Moctezuma
LICENSING EVALUATOR NAME: Miguel Herrera
LICENSING EVALUATOR SIGNATURE:	DATE: 10/09/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/09/2023

LIC809 (FAS) - (06/04)

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