195700267-5-9-2024-58-CC-BCLD-D54SK7-20240509135616

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 195700267
Report Date: 05/09/2024
Date Signed: 05/09/2024 01:56:47 PM

Document Has Been Signed on 05/09/2024 01:56 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:	ANANIKYAN FAMILY CHILD CARE		FACILITY NUMBER:	195700267
ADMINISTRATOR/ DIRECTOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 8	CENSUS: 0	DATE:	05/09/2024
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	09:00 AM
MET WITH:	Tatevik Stepanyan, Applicant		TIME VISIT/ INSPECTION COMPLETED:	02:20 PM

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On May 9, 2024 at 9:00 A.M., Licensing Program Analyst (LPA) Brittanee Cleveland conducted an announced pre-licensing inspection at the facility stated above. This is an application for a small family child care home, up to 8 children - ages 2 years of age to 14 years of age. The family childcare home will operate Monday through Friday 8:00 a.m. to 6:00 p.m. LPA met with Applicant, Tatevik Stepanyan, who guided LPA on a tour of the inside and outside of the home. Applicant’s husband was also present in the home. LPA observed no adults and no children in care.

Applicant submitted paperwork to El Segundo North Regional Office (ESNRO) with her maiden name, Ananikyan. Per applicant, she has legally changed her last name to her married name, Stepanyan.

This is a one-story home which consists of 2 bedrooms, 2 bathrooms, kitchen, dining room, living room, family room, front yard, and backyard (fenced). The children use the bathroom in the first hallway on left. Per applicant, areas off limits to children and parents include: 1 bedroom, 1 bathroom ( connected to master bedroom), and the kitchen. These areas are being kept locked and barricaded during the operating hours. Bedroom #1 will serve as an isolation area if a child is to be sick while in care. The applicant will provide food for children in care.

There is a garage connected to the home that was converted into a home for the owner of the property. This area is off limits to children. The garage includes a living room/kitchen area and a bedroom. LPA has requested for the owner to have background clearance and tuberculosis (TB) test conducted, since owner will reside in the garage. There are no ways to access the garage from inside the main home where daycare will be.

Individuals who reside in the home were noted and discussed. -- Page 1

SUPERVISORS NAME: Raul Navarro
LICENSING EVALUATOR NAME: Brittanee Cleveland
LICENSING EVALUATOR SIGNATURE:	DATE: 05/09/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/09/2024

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: ANANIKYAN FAMILY CHILD CARE	FACILITY NUMBER: 195700267
	VISIT DATE: 05/09/2024

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Applicant states that there are no firearms stored in the home.

All areas identified on the facility sketch that are accessible for children to use were inspected for safety, comfort, and cleanliness. There is telephone service via a cellphone that is used, and the cellphone stays at the facility during operation hours. There is ventilation and heating screen in hallway on the wall. Safe toys play equipment and materials were observed. LPA advised applicant that fireplace needs a gate so it can be inaccessible to children.

Detergents, cleaning compounds, medications, and other items which could pose a danger to children were observed to be inaccessible to children. Poisons are locked in a cabinet in the kitchen, which is off limits to children. The restroom that children use was observed to be safe and sanitary. LPA advised applicant to remove any hand sanitizer and disinfectant wipes from children’s restroom.

The valve on the required 2A 10BC fire extinguisher indicates fully charged and was serviced in April 2024, as indicated on service tag. Smoke detectors were tested and are operable. LPA advised applicant to have fire extinguisher serviced every year. There does not carbon monoxide detector in home at the time of the inspection. LPA informed applicant that a carbon monoxide detector must be installed in home in order to be licensed. Applicant must send proof of purchase and photo when detector is installed.

Applicant states that they will not be caring for infants.

Due to applicant operating from 8:00 AM to 6:00 PM, LPA discussed sleeping and napping arrangements for children in care.

Children will use the backyard for outdoor play time. The outdoor play area was observed to be fenced. LPA observed a rock barrier in the area where children will play. LPA informed applicant to barricade rocks to avoid injury to children. There are safe toys in the area for children to play with. Applicant stated buying more toys for children. LPA advised to secure the swing set in the backyard to ensure safety of the children. LPA observed a trampoline in the backyard. LPA informed the applicant that the trampoline can pose a risk for younger children and should be removed.
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SUPERVISORS NAME: Raul Navarro
LICENSING EVALUATOR NAME: Brittanee Cleveland
LICENSING EVALUATOR SIGNATURE:	DATE: 05/09/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/09/2024

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: ANANIKYAN FAMILY CHILD CARE	FACILITY NUMBER: 195700267
	VISIT DATE: 05/09/2024

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The applicant has completed training on preventive health practices including Pediatric First Aid and CPR. The applicant's Pediatric First Aid and CPR expires in January 2026. There are first aid supplies available. LPA advised that if a child shows signs of illness, they shall be separated from other children. The first bedroom of the house will serve as the isolation room for sick children.

The applicant does have proof of immunization against influenza, pertussis, and measles.

LPA observed that the applicant and assistant does of the Mandated Reporter AB 1207 compliant Child Care Training Certificate on file.

LPA informed applicant that all homes shall conduct fire and disaster drills at least once every six months and document the date and time of each drill.

There are no pets on the premises.

LPA did not observe any pools, spas, hot tubs, fish ponds, or similar bodies of water during the inspection.

Smoking is prohibited in a licensed Family Child Care Home. Per Applicant, no one smokes in the home.

Because the applicant rents/leases the home, proof of landlord notification is required. The LPA observed the Property Owner/Landlord Notification form (UC9151) that the applicant confirms was provided to the property owner/landlord. The applicant obtained a signed Property Owner/Landlord Consent form (UC 9149).

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.

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SUPERVISORS NAME: Raul Navarro
LICENSING EVALUATOR NAME: Brittanee Cleveland
LICENSING EVALUATOR SIGNATURE:	DATE: 05/09/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/09/2024

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: ANANIKYAN FAMILY CHILD CARE	FACILITY NUMBER: 195700267
	VISIT DATE: 05/09/2024

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.
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.

In December 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 childcare by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California.

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 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.

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SUPERVISORS NAME: Raul Navarro
LICENSING EVALUATOR NAME: Brittanee Cleveland
LICENSING EVALUATOR SIGNATURE:	DATE: 05/09/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/09/2024

LIC809 (FAS) - (06/04)

Page: 4 of 5

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: ANANIKYAN FAMILY CHILD CARE	FACILITY NUMBER: 195700267
	VISIT DATE: 05/09/2024

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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.

LPA has requested the following corrections for the family childcare home. Applicant must provide pictures, receipts and documentation of purchase of fireplace gate and carbon monoxide detector. Applicant must also send photos of the rock barrier in the backyard being fenced off from children’s play area. Applicant will send photo of locks in kitchen drawers. A new form Application for Family Child Care Home License (LIC 279) and Emergency Disaster Plan for Family Child Care Homes (LIC 610A) must be completed by applicant to indicate applicant’s married last name. The owner of the property must complete a background check and tuberculosis test, if living in garage area. Applicant must send photo of isolation room, parent board and covered barbecue pit. Applicant must send photo of the removal of the trampoline in backyard. Doorknob covers will be required for the closets across from children’s restroom and isolation room. Applicant must send photo of the swing set being secured to the ground.

LPA informed applicant that after all proof of corrections have been received, the application and report will go under a final review with a Licensing Program Manager (LPM), who will determine completion to obtain license.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the applicant, Tatevik Stepanyan.

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SUPERVISORS NAME: Raul Navarro
LICENSING EVALUATOR NAME: Brittanee Cleveland
LICENSING EVALUATOR SIGNATURE:	DATE: 05/09/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/09/2024

LIC809 (FAS) - (06/04)

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