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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 195700172
Report Date: 09/13/2023
Date Signed: 09/13/2023 11:53:49 AM

Document Has Been Signed on 09/13/2023 11:53 AM - 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:SEVOYAN FAMILY CHILD CAREFACILITY NUMBER:
195700172
ADMINISTRATOR:GAYANE SEVOYANFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(747) 273-9443
CITY:NORTH HOLLYWOODSTATE: CAZIP CODE:
91605
CAPACITY: 14TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
09/13/2023
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
08:00 AM
MET WITH:Gayane Sevoyan, applicantTIME COMPLETED:
11:35 AM
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Pre-Licensing Visit Conducted In Armenian
Licensing Program Analysts (LPAs) Silva Garibyan and Joe Katrdzhyan conducted a change of location pre-licensing inspection on 09/13/2023 at 8:00AM. LPAs met with Gayane Sevoyan, applicant who guided analysts on a tour of the facility. Home is located on a lot with a back house with address: 7129 Goodland Ave, North Hollywood, CA 91605. Applicant is applying for a Large Family Child Care Home with a capacity of 14 children, ages 1 to 13 years old. Licensee is currently licensed as a large Family Child Care Home under facility # 197494217 (effective date: 06/21/2019). The Fire clearance was granted on 08/14/2023 by LA City Fire Prevention Bureau (inspector Shawn Connolly). Applicant’s proposed days and hours of operation are Monday – Friday, from 7:30 AM - 5:00 PM. Entrance Checklist was provided to the applicant. Applicant stated that a cell phone with active service in the home will be the main contact number while children are in care.

All areas identified on the facility sketch were inspected, including but not limited to, off limit areas. This is a single story home that consists of 2 bedrooms, 2 bathrooms, living room, dining room, family room, and kitchen. Parents and children will use the side gate (from Barbara Ann Street) leading to the back yard.

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SUPERVISORS NAME: Betty Bell
LICENSING EVALUATOR NAME: Silva Garibyan
LICENSING EVALUATOR SIGNATURE: DATE: 09/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/13/2023
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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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: SEVOYAN FAMILY CHILD CARE
FACILITY NUMBER: 195700172
VISIT DATE: 09/13/2023
NARRATIVE
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Per applicant, the children will use the following areas: Bedroom 1, Family room, and Bathroom (1) in bedroom 1.

The back door will be used to access the back yard. Kitchen cabinets were observed and inspected. The stove, refrigerator, sink and counter space area were observed and inspected. Knifes and sharp objects observed to be made inaccessible to the children in care. Applicant confirmed that facility will be providing meals and snacks. LPA discussed food preparation, storage and ensuring a log and information regarding dietary restrictions and allergies are kept up to date.

Applicant has submitted a disaster plan. The applicant has completed preventive health and safety/Childhood Nutrition/ Lead Exposure Prevention and Mandated Reporter training (completed on 09/13/2023)). The applicant has current pediatric CPR/First Aid training completed on 04/08/2023. Bedrooms were observed and inspected. Applicant has designated Bedroom(2), living room, dining room, kitchen, and Bathroom(1) as OFF LIMIT to the children in care. LPA observed bedroom doors with locks making off limit areas inaccessible. The bathroom that children will use is in Bedroom (1). two toilets and a sink was observed. The bathroom was observed to be free of hazards. Applicant confirmed no fire arms or weapons are in the home. LPAs toured the outdoor area. Children will utilize the back yard to play. The back yard is fully fenced with no bodies of water. Applicant is stating that when children are having outside time she will ensure 100% supervision and never leave children unattended.

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SUPERVISORS NAME: Betty Bell
LICENSING EVALUATOR NAME: Silva Garibyan
LICENSING EVALUATOR SIGNATURE:

DATE: 09/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/13/2023
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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: SEVOYAN FAMILY CHILD CARE
FACILITY NUMBER: 195700172
VISIT DATE: 09/13/2023
NARRATIVE
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Family room and Bedroom (1) was observed to have children size tables and chairs, napping cots, and a variety of age appropriate materials. LPAs observed emergency water and first aid kit in the family room. Children will eat and sleep in the family room and in Bedroom 1. LPAs observed applicant test the carbon monoxide and smoke detector in the family room and bedroom 1. LPAs observed a fire extinguisher (3A40BC) mounted in the family room, outside, and Bedroom 1. All electrical outlets in the home were covered. LPAs observed the fireplace with mesh drape located in the living room.

Applicant owns the home. The applicant provided proof of control of property by showing the mortgage statement.


Applicant was reminded that all adults 18 and over living in the home, persons who provide care and supervision to children, and staff who have contact with children, 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.
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) or (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.
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SUPERVISORS NAME: Betty Bell
LICENSING EVALUATOR NAME: Silva Garibyan
LICENSING EVALUATOR SIGNATURE:

DATE: 09/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/13/2023
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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: SEVOYAN FAMILY CHILD CARE
FACILITY NUMBER: 195700172
VISIT DATE: 09/13/2023
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LPAs reviewed with applicant the LIC 311D, Forms/Records to Keep In Your Family Child Care Homes, children’s forms/records, facility forms/records, and information to be posted. Entrance Checklist was provided to the applicant.
LPAs discussed the safe sleep regulations with applicant 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.
LPAs also informed applicant 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.
On 07/27/2023, the California Attorney General - Megan’s Law website was searched for information on sex offenders required to register with local law enforcement under California's Megan's Law. No registered sex offenders were found at the facility addresses. Under state law, some registered sex offenders are not subject to public disclosure; therefore, they may not have been included in this search. However, the Department conducts a monthly cross reference of each address on record for all registered sex offenders against all CCLD facility addresses pursuant to information shared by California DOJ.

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SUPERVISORS NAME: Betty Bell
LICENSING EVALUATOR NAME: Silva Garibyan
LICENSING EVALUATOR SIGNATURE:

DATE: 09/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/13/2023
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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: SEVOYAN FAMILY CHILD CARE
FACILITY NUMBER: 195700172
VISIT DATE: 09/13/2023
NARRATIVE
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Applicants were informed of the MyChildCarePlan.org site, a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platforms. To receive important licensed related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-carelicensing/subscribe and select the Child Care option to receive email communication


Applicants were informed that the following is pending licensure and needs to be corrected within 30 days from the date of this report
  • Parent board with posting requirements according to Title 22 Regulations.


Exit interview conducted and report was reviewed with the applicants, Gayane Sevoyan.

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SUPERVISORS NAME: Betty Bell
LICENSING EVALUATOR NAME: Silva Garibyan
LICENSING EVALUATOR SIGNATURE:

DATE: 09/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/13/2023
LIC809 (FAS) - (06/04)
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