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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 195700085
Report Date: 07/29/2026
Date Signed: 07/29/2026 03:14:41 PM

Document Has Been Signed on 07/29/2026 03:14 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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:VIRABYAN FAMILY CHILD CAREFACILITY NUMBER:
195700085
ADMINISTRATOR/
DIRECTOR:		DAVIT VIRABYANFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(818) 281-8426
CITY:VAN NUYSSTATE: CAZIP CODE:
91405
CAPACITY: 14TOTAL ENROLLED CHILDREN: 10CENSUS: 5DATE:
07/29/2026
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:35 PM
MET WITH:Davit VirabyanTIME VISIT/
INSPECTION COMPLETED:
03:45 PM
NARRATIVE
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 On 7/29/2026 at 1:35 PM, Licensing Program Analyst (LPA) Christina Nunez and LPA Melissa Zaragoza conducted a case management visit at the above facility. LPAs met with Licensee Davit Virabyan and observed 5 children in care as well as 1 other staff present. No other adults were in the home and there was one minor family member.

The purpose of the visit is to discuss the matter of the new Family Child Care Home application submitted by Applicant Maria Dolmazyan for address 15045 Leadwell St Van Nuys, CA 91405. The Applicant is requesting a Small Family Child Care Home license for a capacity of 8 to provide care from an Accessory Dwelling Unit (ADU) located behind the main house, 15047 Leadwell St Van Nuys, CA 91405 where the licensee, Davit Virabyan, resides and operates Virabyan Family Child Care Home #195700085. Per Licensee, they’re relationship is familial as Maria is Davit’s mother.

LPAs inquired about the continued association Licensee has with, Dolmazyan Family Child Care Home #195700740 and how, if Applicant is licensed, Licensee plans to directly supervise children and operate their own Family Child Care Home from the hours of 5:30 AM to 11:30 PM Monday to Saturday. Licensee stated that he will not interfere with Applicant's facility and she will not interfere with his by locking doors and making sure staff does not interfere as well. Licensee states that since he is the property Landlord, anything that needs to be discussed about the property will be done after operating hours. During operating hours, Licensee will stay within the boundaries of his facility and Applicant will stay within the boundaries of theirs.

LPAs reminded Licensee that although both facilities are located on the same property, there shall be no commingling between the two licenses. Each facility must operate independently and maintain separate children, records, and daily operations at all times. -Page 1.

Raul Navarro
Christina Nunez
DATE: 07/29/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/29/2026
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 4
California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: VIRABYAN FAMILY CHILD CARE
FACILITY NUMBER: 195700085
VISIT DATE: 07/29/2026
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Licensee Davit Virabyan provided a signed declaration during this case management visit noting that if Maria Dolmazyan is licensed, they will not commingle children, they will be present at the facility and always provide direct care and supervision of children independently of each other.

On 3/10/2026, Applicant Maria Dolmazyan submitted LIC 279 application for a Family Child Home License. Per review of Virabyan facility file, LIC 279 lists Maria Dolmazyan as an adult residing in the home and the department has not been made aware of any changes as of 7/28/2026. Per regulation 102416.2 Reporting Requirements (a) The licensee shall report the following information the Department by telephone or fax within the Department's next business day and during normal working hours (8am to 5pm) (2) Any change in household composition including adults moving in or out of the home and anyone living in the home who reaches his or her 18th birthday. Type B citation issued and LPAs reminded Licensee that the department must be notified of any and all changes made in the future. Licensee expressed concern about Type B citation and how it will reflect on the facility. LPAs explained that this citation is not a civil penalty or criminal offense and is appealable.

Exit interview conducted with Licensee Davit Virabyan, appeal rights were provided and notice of site visit and must remain posted for 30 days.

-Page 2.

NAME OF LICENSING PROGRAM MANAGER: Raul Navarro
NAME OF LICENSING PROGRAM ANALYST: Christina Nunez
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 07/29/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/29/2026
LIC809 (FAS) - (06/04)
Page: 3 of 4
Document Has Been Signed on 07/29/2026 03:14 PM - It Cannot Be Edited


Created By: Christina Nunez On 07/29/2026 at 02:51 PM
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
, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: VIRABYAN FAMILY CHILD CARE
FACILITY NUMBER: 195700085

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/29/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Deficiency Dismissed
Type B
08/12/2026
Section Cited
CCR
102416.2(a)(2)

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102416.2 Reporting Requirements (a) The licensee shall report the following information the Department by telephone or fax within the Department's next business day and during normal working hours (8am to 5pm) (2) Any change in household composition including adults moving in or out of the home and anyone living in the home who reaches his or her 18th birthday.

This requirements is not met as evidence by:
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As a plan of correction, Licensee states they will submit an updated LIC 279 application form listing all current adults who reside in the home and report any changes in the home in a timely manner in the future.
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Based on record review, the licensee did not comply with the section cited above by not reporting to the department changes to the composition of the home, which poses a potential health, safety or personal rights risk to persons in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Raul Navarro
NAME OF LICENSING PROGRAM MANAGER:
Christina Nunez
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 07/29/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/29/2026


LIC809 (FAS) - (06/04)
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