195700272-6-19-2025-58-CC-ECAO-DHSNRS-20250619104202

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 195700272
Report Date: 06/19/2025
Date Signed: 06/19/2025 10:42:23 AM

Document Has Been Signed on 06/19/2025 10:42 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:	TOVMASYAN FAMLY CHILD CARE		FACILITY NUMBER:	195700272
ADMINISTRATOR/ DIRECTOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 8	CENSUS: 2	DATE:	06/19/2025
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	08:03 AM
MET WITH:	Artak Tovmasyan, Licensee		TIME VISIT/ INSPECTION COMPLETED:	11:30 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	On 06/19/2025, Licensing Program Analysts (LPA) Elicia Calvillo conducted an unannounced annual and capacity increase inspection at 2707 N. Kenneth Road, Burbank, CA 91504. LPA arrived at the facility at 08:03 AM, identified self and met with Artak Tovmasyan, Licensee, who guided analyst on a tour of the inside and outside of the facility. There were 2 children present at arrival. Also present were three (3) adult residents. LPA provided Licensee with a copy of the LIC125 Entrance Checklist to help facilitate the inspection. Facility operation hours are Monday to Friday from 7:00AM to11:00PM. The family child care home is one story dueling with a combined living/dining/kitchen Room, 3 bedrooms, and 3 bathrooms, and no garage. There is a front yard that will be used for dropping off and picking up children. There is a fenced outdoor play area in the back of the house. There is an Accessory Dwelling Unit (ADU) located on the same property with address 2709 N. Kenneth Road, Burbank, CA 91504. Licensee stated that they will update their Facility Sketch (Yard) to include the location of the ADU. The children enter the child care home from the front door. LPA observed the living room and bathroom #1 will be used for child care and accessible to parents and children. The living room will be used for child activities, music, reading, learning activities, sleeping, and eating. LPA observed eight (8) cots, bed linens (provided by Licensee), 12 chairs, three (3) tables, toys and play items that are safe, clean and appropriate for the ages of the children. Licensee stated they will purchase six (6) additional cots and two (2) additional chairs. PAGE 1 OF 5

NAME OF LICENSING PROGRAM MANAGER: Rita Ramos
NAME OF LICENSING PROGRAM ANALYST: Elicia Calvillo
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 06/19/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/19/2025

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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California Health & Human Services Agency

California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:

Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.

Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)

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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: TOVMASYAN FAMLY CHILD CARE	FACILITY NUMBER: 195700272
	VISIT DATE: 06/19/2025

NARRATIVE

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LPA observed the children will have access to bathroom #1 in the hallway near bedroom #1 and bedroom #2. The vanity cabinet holds paper products, personal items, no hazards were observed, and the cabinet is secured with the use of a child proof latch. LPA observed that the bathroom that children will use was safe and sanitary.

Licensee stated that when a child shows signs of an illness the child will isolated away from the other children.

The dining/kitchen, bedroom #1, bedroom #2, bedroom#3, bathroom #2, bathroom #3, and laundry room are off-limits to parents and children and made inaccessible by use of safety door locks and child gates.

There is telephone service via a cellphone and LPA advised Licensee that the cellphone must remain in the child care home during the operation hours.

There is device on the wall and Licensee identified it as the fire alarm, there is a smoke detector in the living room, each bedroom is equipped with a smoke detector and there is carbon monoxide detector in kitchen; and were tested and are operable. There is a working fire extinguisher, the valve on the required 2A:10BC fire extinguisher indicates fully charged and Licensee confirmed the purchase date was 01/10/2025. LPA did observe a fireplace in the living room and is made inaccessible with the use of a metal gate and two (2) covers. Licensee stated the fireplace does not work. There is adequate heating and ventilation for safety and comfort.

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

Per Licensee, there are no firearms or ammunition on the premises. No poisons were observed during the inspection. Detergents, cleaning compounds, medication and other hazardous items are made inaccessible with the use of a safety latch.

Licensee stated there are not pets on the premises. LPA did not observe any pets on the premises.

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NAME OF LICENSING PROGRAM MANAGER: Rita Ramos
NAME OF LICENSING PROGRAM ANALYST: Elicia Calvillo
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 06/19/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/19/2025

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: TOVMASYAN FAMLY CHILD CARE	FACILITY NUMBER: 195700272
	VISIT DATE: 06/19/2025

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There are currently one (1) infant in care under the age of 12 months. LPA observed that the infant is checked on every 15 minutes and the time of each 15-minute check was documented with child’s name and date. Licensee stated that the will complete the LIC 9227 Individual Infant Sleeping Plan for each infant up to 12 months of age and reference Provider Information Notice (PIN) 20-24 CCP.

LPA discussed the safe sleep regulations with Licensee 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 Licensee 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.

Licensee was reminded that children in care are to be supervised at all times and made aware that children shall not be left in parked vehicles. Car seats are used for transportation purposes only and are not used for sleeping children.

The outdoor play area is located on the back yard of the house, is fenced and there are no hazards to children present. LPA observed there are toys and play equipment that are free of sharp pointed parts, in good repair, and appropriate for the ages of the children.

Capacity as specified on the license is being maintained.

LPA reviewed a sample of children’s files and observed files were complete and documented on the LIC857.

An emergency fire/disaster drill has been completed within the last 6 months on 04/25/2025 and the documentation of the fire/disaster drill was not readily available upon request. Licensee’s Mandated Reporter Training was completed on 06/04/2025 and an updated completion certificate was not available upon inspection. Licensee’s pediatric CPR/First Aid expired on 06/2027.

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NAME OF LICENSING PROGRAM MANAGER: Rita Ramos
NAME OF LICENSING PROGRAM ANALYST: Elicia Calvillo
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 06/19/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/19/2025

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: TOVMASYAN FAMLY CHILD CARE	FACILITY NUMBER: 195700272
	VISIT DATE: 06/19/2025

NARRATIVE

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All adults who reside or work in the home have a criminal record clearance or exemption. There are no excluded individuals present at this home.

Licensee was reminded that all adults 18 and over living or working in the home, 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)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: https://www.ada.gov/resources/child-care-centers/.

During the exit interview, the Licensee, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

Licensee was informed of the MyChildCarePlan.org website; 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.

To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

During today’s visit, per Title 22, Division 12, Chapter 3, of the California Code of Regulations, there were no citations issued.

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NAME OF LICENSING PROGRAM MANAGER: Rita Ramos
NAME OF LICENSING PROGRAM ANALYST: Elicia Calvillo
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 06/19/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/19/2025

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: TOVMASYAN FAMLY CHILD CARE	FACILITY NUMBER: 195700272
	VISIT DATE: 06/19/2025

NARRATIVE

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Before the Capacity Increase approval, the following items need to be corrected by 07/19/2025.
Purchase two (2) additional chairs
Purchase six (6) additional cots
Update the Facility Sketch (Yard) to include the location of the ADU.

A Notice of Site Visit was given and must remain posted for 30 days during the hours of operation after each site visit by a licensing representative. Failure to comply with posting requirement will result in an immediate civil penalty of $100.00.

Exit interview was conducted with Artak Tovmasyan, Licensee including, but not limited to Provider Rights, Appeal Procedures and Agencies Consultative Role.

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NAME OF LICENSING PROGRAM MANAGER: Rita Ramos
NAME OF LICENSING PROGRAM ANALYST: Elicia Calvillo
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 06/19/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/19/2025

LIC809 (FAS) - (06/04)

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