195700216-12-14-2023-58-CC-SGAN-CYHRB3-20231214115203

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 195700216
Report Date: 12/14/2023
Date Signed: 12/14/2023 11:54:53 AM

Document Has Been Signed on 12/14/2023 11:54 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:	MNATSAKANYAN FAMILY CHILD CARE		FACILITY NUMBER:	195700216
ADMINISTRATOR:	GOR MNATSAKANYAN		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(310) 307-6870
CITY:	SHERMAN OAKS	STATE: CA	ZIP CODE:	91403
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 0	CENSUS: 0	DATE:	12/14/2023
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	08:00 AM
MET WITH:	Gor Mnatsakanyan, Licensee		TIME COMPLETED:	11:45 AM

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	Pre-Licensing Visit Conducted In Armenian Licensing Program Analyst (LPA) Silva Garibyan conducted a pre-licensing inspection on 12/14/2023 at 8:00AM. LPA met with Gor Mnatsakanyan, applicant who guided analyst on a tour of the facility. The applicant is requesting large family child care home license with a capacity of 14. The applicant was previously licensed ( co-licensee since 2019, Licence # 197494320) and qualifies for a large family child care license. The applicant has installed the pull fire alarm that is required for large Family Child Care Homes and has an approved fire clearance. Per applicant operation hours will be Monday to Friday 7:30 AM-5:30 PM. Applicant will care for children newborn to 14 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 licensee only. Licensee's home shares the same property as the front house with a different address (4840 Vista Del Monte Ave, Sherman Oaks, CA 91403). The front house is currently vacant. The properties are separated by a fence. Applicant confirmed that families will enter the home through the alley located in the back of the property. All areas identified on the facility sketch were inspected, including but not limited to off limit areas. This is a two story home that consists of three bedrooms, three bathrooms, living/dining room, kitchen, and laundry area. Per applicant, the children will use the following areas: Living/Dining room and Bathroom 1. Page 1

SUPERVISORS NAME: Betty Bell
LICENSING EVALUATOR NAME: Silva Garibyan
LICENSING EVALUATOR SIGNATURE:	DATE: 12/14/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/14/2023

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: MNATSAKANYAN FAMILY CHILD CARE	FACILITY NUMBER: 195700216
	VISIT DATE: 12/14/2023

NARRATIVE

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Entire second floor (including three bedrooms, two bathrooms, and laundry area) is off limits to the children in care. Safety gates are installed by the stairs to make the second floor inaccessible. Safety gate and shelves are installed to make the kitchen inaccessible. 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. The bathroom that children will use is on the first floor. A toilet and a sink was observed. The bathroom was observed to be free of hazards. Children will utilize the back/side 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 03/24/2022). The applicant has current pediatric CPR/First Aid training completed on 04/03/2023.

Living/Dining room was observed to have children size tables, chairs, play yard and variety of age appropriate materials. LPA observed emergency water and first aid kit in the kitchen. Children will eat and sleep in the Living/Dining room. LPA observed applicant test the carbon monoxide/smoke detectors in the Living/Dining room. LPA observed a fire extinguisher (2A10BC) mounted in kitchen. All electrical outlets in the home were covered. Per applicant, there are no weapons or firearms of any kind in the facility at this time. The LPA did not observe any weapons.

Applicant owns the home. The applicant provided proof of control of property ( Property Tax Statement). Page 2

SUPERVISORS NAME: Betty Bell
LICENSING EVALUATOR NAME: Silva Garibyan
LICENSING EVALUATOR SIGNATURE:	DATE: 12/14/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/14/2023

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: MNATSAKANYAN FAMILY CHILD CARE	FACILITY NUMBER: 195700216
	VISIT DATE: 12/14/2023

NARRATIVE

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Applicants 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.
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.
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. Page 3

SUPERVISORS NAME: Betty Bell
LICENSING EVALUATOR NAME: Silva Garibyan
LICENSING EVALUATOR SIGNATURE:	DATE: 12/14/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/14/2023

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: MNATSAKANYAN FAMILY CHILD CARE	FACILITY NUMBER: 195700216
	VISIT DATE: 12/14/2023

NARRATIVE

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On 10/30/2023, 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.

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 applicants, Gor Mnatsakanyan. Page 4

SUPERVISORS NAME: Betty Bell
LICENSING EVALUATOR NAME: Silva Garibyan
LICENSING EVALUATOR SIGNATURE:	DATE: 12/14/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/14/2023

LIC809 (FAS) - (06/04)

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