195700177-9-6-2023-58-CC-SORS-CVEUH3-20230906153516

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 195700177
Report Date: 09/06/2023
Date Signed: 09/06/2023 03:35:26 PM

Document Has Been Signed on 09/06/2023 03:35 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:	NIGIYAN FAMILY CHILD CARE		FACILITY NUMBER:	195700177
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 0	CENSUS: 0	DATE:	09/06/2023
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME BEGAN:	01:20 PM
MET WITH:	ASYA NIGIYAN- Licensee		TIME COMPLETED:	03:45 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	On 9/6/2023, Licensing Program Analyst (LPA) Suzette Ornelas conducted an announced Relocation Pre-Licensing Inspection at 7818 N GLENOAKS BLVD BURBANK CA 91504. The purpose of the meeting was to ensure that health, safety and personal rights as required by Title 22 Regulations governing California Family Child Care homes will be met by the Licensee. This is an application for a Small Family Child Care Home, 8 children-ages Infant to 14 years of age. The family child care home will operate Monday through Friday 24 hours. LPA met with Applicant, ASYA NIGIYAN, who guided LPA on a tour of the inside and outside of the home. LPA observed 1 adult and 0 children in care. Per facility sketch and tour of the home, the following was observed and discussed with the Applicant during the inspection: Home is a 1-story dwelling with a living room, dining room, kitchen, 1 bathroom located in the hallway, 1 bedroom, 1 master bedroom with master bathroom/laundry room. The garage is inaccessible and tenant does not have access to the garage. The home has a locked gates on both sides of the home leading to the backyard. The home is equipped with a Ring camera doorbell. LPA observed the following: · The living room area is on-limits and will be used for child care activities and napping. Electrical outlets have safety covers installed. Living room has a fireplace, which has been screened to prevent access by children. · Bathroom located in the hallway is on-limits and accessible to children in care. · Dining Room area is on-limits to children in care. This room is equipped with one working dual carbon monoxide/smoke detector, as tested by the Applicant. · The kitchen is on-limits to children in care as the space will remain open. Kitchen cabinet and drawers containing hazardous materials and sharp objects are made inaccessible by safety latches. · Bedroom 1 is on limits and will be used for child care activities and napping. Electrical outlets have safety covers installed. Pg1

SUPERVISORS NAME: Betty Bell
LICENSING EVALUATOR NAME: Suzette Ornelas
LICENSING EVALUATOR SIGNATURE:	DATE: 09/06/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/06/2023

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: NIGIYAN FAMILY CHILD CARE	FACILITY NUMBER: 195700177
	VISIT DATE: 09/06/2023

NARRATIVE

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· Master bedroom and master bathroom/laundry room is off limits to children in care and will be made inaccessible by a locked door.
· Front yard is on limits when children enter the home. The front yard will be used as a play area. Front yard is fenced in and secure.
· Backyard is on-limits to children in care and will be accessed through bedroom 1.

The following was also observed by LPA during the inspection
1. All adults living in the home have submitted fingerprints and child abuse index check forms to Department of Justice.
2. Home is neat and clean.
3. Fireplace is screened and inaccessible to children.
4. Home is equipped with a fully charged fire extinguisher which is at least a 2A:10BC.
5. Home is equipped with at least 2 working smoke alarm and a carbon monoxide detectors.
6. Home has a working telephone.
7.All poisons, detergents, cleaning compounds, medications, etc. are inaccessible to children or are locked.
8. Hazardous materials are inaccessible and kept out of the reach of children.
9. According to the Applicant, there are no weapons or firearms in the home. LPA did not observe weapons.
10.Outdoor play area is free from defects or dangerous conditions.
11.Outdoor area is fenced. Applicant will install a baby gate to ensure children’s safety.
12.Home does have a swimming pool, covered or fenced. The fence is at least 5 feet high with a self-latching gate that opens away from the pool or body of water. If using a cover, it must support the weight of an adult and shall be locked when pool is not in use.
13.Toys and play items are safe, clean, and appropriate for the ages of the children.
14.Applicant agrees that baby-walkers, bouncers, jumpers, and similar items will not be used for children in care and are kept inaccessible.
15.The home is equipped with a first-aid kit equipped with, cleansing pads healing ointment, bandages, gauze, and a digital thermometer.
The following was thoroughly discussed with the Applicant
· Applicant was made aware of The Child Care Advocate Program (CCAP) that is administered from within the Community Care Licensing Division. CCAP participates in many community activities and special projects in order to disseminate information on the State’s licensing role, provide information to the public and parents on child care licensing, and provide many other helpful resources to the licensees and the public. CCAP’s direct contact information is as followed: Phone number: (916) 654-1541.
Email Address: childcareadvocatesprogram@dss.ca.gov
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SUPERVISORS NAME: Betty Bell
LICENSING EVALUATOR NAME: Suzette Ornelas
LICENSING EVALUATOR SIGNATURE:	DATE: 09/06/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/06/2023

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: NIGIYAN FAMILY CHILD CARE	FACILITY NUMBER: 195700177
	VISIT DATE: 09/06/2023

NARRATIVE

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·Commencing September 1, 2016, SB 792, prohibits a person from being employed or volunteering at a child care facility or family day care if he or she has not been immunized against influenza, pertussis and measles. LPA discussed the influenza waiver during the inspection.

· Beginning on January 1, 2018, AB 1207, requires all licensed providers, applicants, directors and employees to complete training as specified on their mandated reporter duties and to renew their training every two years. Website: www.mandatedreporterca.com. Licensee was reminded of their responsibility to report suspected child abuse.

· Upon receipt by the licensee, licensees are to provide to parents/guardians the following: Copies of any licensing reports that document a Type A citation- this includes facility visits and substantiated complaint investigations; copy of licensing documents pertaining to a conference conducted by a local licensing agency management representative and the licensee of this family child care home in which issues of noncompliance are discussed or copies of a summary of an accusation indicating the Department's intent to revoke the facility's license. Copies of any of the above licensing documents the licensee has received in the prior 12 months shall be provided to parents/guardians of newly enrolled child at the facility. (AB) 633

· Applicant was advised that regulation prohibits the smoking of tobacco in a private residence licensed as a family child care home during the hours of operation.

· The fire extinguisher type 2A-10BC must be services annually or as often as necessary. Smoke and carbon monoxide detectors should be checked, and batteries should be replaced.

· A current roster of children enrolled must be maintained and available. 1596.841

· Applicant was reminded to report any unusual incidents or injuries to the Child Care Regional Office by telephone within 24 hours and in writing within 7 days.

· Applicant was reminded that all infants must be placed on their backs when sleeping to prevent S.I.D.S. (Sudden Infant Death Syndrome) and that the Provider is required to wash hands after every diaper change and to never shake a baby to prevent the Shaken Baby Syndrome. Safe to Sleep Campaign: https://safetosleep.nichd.nih.gov/materials 19-02 CCP Safe Sleep Awareness Campaign
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SUPERVISORS NAME: Betty Bell
LICENSING EVALUATOR NAME: Suzette Ornelas
LICENSING EVALUATOR SIGNATURE:	DATE: 09/06/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/06/2023

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: NIGIYAN FAMILY CHILD CARE	FACILITY NUMBER: 195700177
	VISIT DATE: 09/06/2023

NARRATIVE

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·Applicant was reminded that only children eating may be in highchairs and that car seats are utilized only for transportation.

· Applicant was made aware that state law prohibits baby walkers, bouncy seats, exersaucers and any other items that fall into that category. 1596.846(b)(c)

· Applicant was reminded that it is the licensee’s, as well as anyone who assists in providing care, responsibility to know the regulations. Licensee was advised on how to access quarterly reports, forms, and regulations for Child Care online at www.ccld.ca.gov. Licensee was also encouraged to read the Child Care quarterly updates as they come out to stay informed of any changes or updates to statutes and regulations.

· In the absence of the licensee a qualified adult must be present supervising the children; a qualified adult is an individual who has a valid and current adult/infant CPR& Pediatric First Aid certification and a valid criminal record clearance associated to the facility license.

· Due to the COVID-19 pandemic and local and state ordinances, licensee was directed to the CCLD.CA.GOV website for important updates and PINS. Licensee was directed to PIN 22-10-CCP.

Proof of corrections have been discussed with Applicant, including:
· Baby gate will be installed in the backyard area to prevent children from accessing off limit side area of the home.

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.

The applicant provided proof of control of property. Because the applicant rents/leases the home, proof of landlord notification is required. The LPA observed the Property Owner/Landlord Notification form (LIC9151) that the applicant confirms was provided to the property owner/landlord. The applicant obtained a signed Property Owner/Landlord Consent form (LIC 9149).
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SUPERVISORS NAME: Betty Bell
LICENSING EVALUATOR NAME: Suzette Ornelas
LICENSING EVALUATOR SIGNATURE:	DATE: 09/06/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/06/2023

LIC809 (FAS) - (06/04)

Page: 4 of 6

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: NIGIYAN FAMILY CHILD CARE	FACILITY NUMBER: 195700177
	VISIT DATE: 09/06/2023

NARRATIVE

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On this date, 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.

LPA 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-and-resources/safe-sleep, as an additional resource. LPA also informed [applicant, 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.

LPA 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.

Applicant was 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-care-licensing/subscribe and select the Child Care option to receive email communication
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SUPERVISORS NAME: Betty Bell
LICENSING EVALUATOR NAME: Suzette Ornelas
LICENSING EVALUATOR SIGNATURE:	DATE: 09/06/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/06/2023

LIC809 (FAS) - (06/04)

Page: 5 of 6

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: NIGIYAN FAMILY CHILD CARE	FACILITY NUMBER: 195700177
	VISIT DATE: 09/06/2023

NARRATIVE

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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) 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.

Exit interview conducted and report was reviewed with the licensee, ASYA NIGIYAN.

A copy of this report was provided to the Applicant. Final license determination will be made upon review by the Licensing Program Manager and correction of the above issues. Applicant to correct items by 9/22/2023.

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SUPERVISORS NAME: Betty Bell
LICENSING EVALUATOR NAME: Suzette Ornelas
LICENSING EVALUATOR SIGNATURE:	DATE: 09/06/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/06/2023

LIC809 (FAS) - (06/04)

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