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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 195700177
Report Date: 09/27/2023
Date Signed: 09/27/2023 10:26:23 AM

Document Has Been Signed on 09/27/2023 10:26 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:NIGIYAN FAMILY CHILD CAREFACILITY NUMBER:
195700177
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
09/27/2023
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
09:42 AM
MET WITH:ASYA NIGIYAN- LicenseeTIME COMPLETED:
10:35 AM
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On 9/27/2023, Licensing Program Analysts (LPA's) Suzette Ornelas and Joe Katrdzhyan 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's met with Licensee, ASYA NIGIYAN, who guided LPA's on a tour of the inside and outside of the home. LPA's observed 1 adult and 0 children in care.

LPA's inspected the off limits garage that will not be used for children in care. The garage has been converted into a living space. LPA's informed licensee that if there is a tenant that moves into the converted garage in the future, to ensure the individual(s) obtain fingerprint clearance (LIC 9163).



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 and a garage that will be inaccessible to children in care.

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

A copy of this report was provided to the Applicant. LPA's will recommend facility is ready for license to LPM.
SUPERVISORS NAME: Betty Bell
LICENSING EVALUATOR NAME: Suzette Ornelas
LICENSING EVALUATOR SIGNATURE: DATE: 09/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/27/2023
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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