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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 195700204
Report Date: 03/08/2024
Date Signed: 03/08/2024 11:30:24 AM

Document Has Been Signed on 03/08/2024 11:30 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:KARAPETIAN FAMILY CHILD CAREFACILITY NUMBER:
195700204
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 0DATE:
03/08/2024
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
07:30 AM
MET WITH:Goar Karapetian, ApplicantTIME COMPLETED:
11:35 AM
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Pre-Licensing Visit Conducted In Armenian
Licensing Program Analyst (LPA) Silva Garibyan conducted a pre-licensing inspection on 03/08/2024 at 7:30AM. LPA met with Goar Karapetian, applicant who guided analyst on a tour of the facility. The applicant is requesting a small family child care home license with a capacity of 8. Per applicant operation hours will be Monday to Friday from 7:30 am to 10:00 pm. Applicant states she will care for children newborn to 13 years of age. 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. Family members residing in the home include two adults ( applicant and her husband) and three children ( 14, 12, and 7 years old). Applicant was informed that her children under 10 years of age, count in her capacity whenever they are present.

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, kitchen, laundry area, detached accessory room. Parents and children will use the main entry door leading to the living room. All electrical outlets in the home were covered. The fireplace located in the living room is made inaccessible by a screen.

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SUPERVISORS NAME: Betty Bell
LICENSING EVALUATOR NAME: Silva Garibyan
LICENSING EVALUATOR SIGNATURE: DATE: 03/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/08/2024
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: KARAPETIAN FAMILY CHILD CARE
FACILITY NUMBER: 195700204
VISIT DATE: 03/08/2024
NARRATIVE
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 LPA observed child safety latches on all kitchen cabinet doors and drawers. Bedrooms were observed and inspected. Applicant has designated Bedrooms and Bathroom (2) as OFF LIMIT to the children in care. LPA observed bedroom doors with safety knob/locks making off limit areas inaccessible. Per applicant, there are no weapons or firearms of any kind in the facility at this time. LPA did not observe any weapons. LPA observed emergency water and first aid kit in the kitchen. Living room was observed to have two children size tables and eight chairs, six napping cots, a play yard, and a variety of age appropriate materials. Children will eat and sleep in the dining room and in the living room. LPA observed applicant test the carbon monoxide/ smoke detector in the hall way. LPA observed a fire extinguisher (2A10BC) mounted in the living. All electrical outlets in the home were covered. There are no stairs in this home.

The bathroom that children will use is in the living room. A toilet and a sink was observed. The bathroom was observed to be free of hazards. Children will utilize the back yard to play. The yard is fully fenced with no bodies of water. Applicant is stating that when children are having outside time he will ensure 100% supervision and never leave children unattended.

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 09/09/2022). The applicant has current pediatric CPR/First Aid training completed on 09/03/2023.

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

DATE: 03/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/08/2024
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: KARAPETIAN FAMILY CHILD CARE
FACILITY NUMBER: 195700204
VISIT DATE: 03/08/2024
NARRATIVE
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 Licensee has the required documents posted in the FCCH: Emergency Disaster Plan (LIC610A), Notification of Parents' Rights Poster (PUB 394), If You see Something Say Something poster, Safe Sleep poster.


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).

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.

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.

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

DATE: 03/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/08/2024
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: KARAPETIAN FAMILY CHILD CARE
FACILITY NUMBER: 195700204
VISIT DATE: 03/08/2024
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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.

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-andresources/safe-sleep, as an additional resource.
LPA 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 2/01/2024, 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. Page 4 of 5
SUPERVISORS NAME: Betty Bell
LICENSING EVALUATOR NAME: Silva Garibyan
LICENSING EVALUATOR SIGNATURE:

DATE: 03/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/08/2024
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: KARAPETIAN FAMILY CHILD CARE
FACILITY NUMBER: 195700204
VISIT DATE: 03/08/2024
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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-carelicensing/subscribe and select the Child Care option to receive email communication



Exit interview conducted and report was reviewed with the applicant, Goar Karapetian

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

DATE: 03/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/08/2024
LIC809 (FAS) - (06/04)
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