195700286-8-22-2024-58-CC-JKAN-D8DN8N-20240822101436

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 195700286
Report Date: 08/22/2024
Date Signed: 08/22/2024 10:14:44 AM

Document Has Been Signed on 08/22/2024 10:14 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:	ADAMIAN FAMILY CHILD CARE		FACILITY NUMBER:	195700286
ADMINISTRATOR/ DIRECTOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 8	CENSUS: 0	DATE:	08/22/2024
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	08:00 AM
MET WITH:	Applicant / Ani Adamian		TIME VISIT/ INSPECTION COMPLETED:	10:30 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 8/22/24, at 8AM, Licensing Program Analyst (LPA) Joe Katrdzhyan conducted an announced follow up Pre-Licensing Inspection. 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 Applicant. This is an application for a Small Family Child Care Home, for a Capacity of 8 children - ages 0 months to 12 years of age. The family child care home will operate Monday through Sunday, 6AM to 5AM. Upon arrival, LPA met with Applicant / Ani Adamian, who guided LPA on a tour of the inside and outside of the home. LPA observed no children in care.

During the initial pre-licensing inspection conducted on 7/22/24, LPA observed the attached garage had been converted to be used as the main child care room at the home. The garage door was observed to be permanently shut with a wall built on the inside of the room making the garage door inaccessible. After confirming with the Property Owner/Ladlord, the Applicant stated that the room inside the garage was converted to a room without a permit. Per the Applicant, the room inside the garage will not be used as a child care room. Children in care will not have access to the room inside the garage and the room has been made completely inaccessible to children with the use of door with a lock and also a child safety lock . The room is now being used as a storage room. During todays visit, LPA obtained a declaration from the Applicant stating the room inside the garage is off limits and will not be used for children care. A new facility sketch was obtained and also pictures taken.

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 that consists of a living room, kitchen, 2 bedrooms, 2 bathrooms and an attached garage. The home has a locked gate on one side of the home leading to the backyard. LPA observed the following:

Pg. 1 of 3

SUPERVISORS NAME: Rita Ramos
LICENSING EVALUATOR NAME: Joe Katrdzhyan
LICENSING EVALUATOR SIGNATURE:	DATE: 08/22/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/22/2024

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)

Page: 1 of 3

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: ADAMIAN FAMILY CHILD CARE	FACILITY NUMBER: 195700286
	VISIT DATE: 08/22/2024

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
26
27
28
29
30
31
32

· The living room is on limits and will be used for child care. Electrical outlets have safety covers installed. LPA observed 8 child size beds in place. Applicant stated that beds for infants will be purchased in the event infants are admitted for care. Part of the living room will be used as an isolation area as needed.
· The kitchen is off limits and made inaccessible with the use of baby gates, located on each side of the island.
· Bedrooms 1 and 2 are off limits and made inaccessible by the use of a door with a lock and also a child safety lock.
· Bathroom 1 is on limits to children in care.
· Bathroom 2 is off limits and made inaccessible by the use of a door with a lock and also a child safety lock.
· The attached garage is off limits and made inaccessible by the use of a door with a lock and also a child safety lock.
· Part of the backyard (as you exit through the sliding doors from the kitchen) is made off limits to children in care. The play area is located on the back yard, which has been fenced / fully enclosed, separating the play area from the remaining part of the back yard. LPA observed artificial grass located in the pay area designated for children care. LPA advised Applicant that outdoor supervision is required at all times.
· The Front yard is on limits for the purpose of children entering the home. The front yard will not be used as a play area for children in care.
· The applicant states that they will provide breakfast, lunch, dinner and snacks for children in care.
· The facility is equipped with video surveillance (inside and outside).

The following was also observed by LPA Katrdzhyan during the inspection:
1. All adults living in the home have submitted fingerprints and child abuse index check forms to Department of Justice.
2. Home is neat and clean.
3. The home does not have a fireplace.
4. Home is equipped with a fully charged fire extinguisher which is at least a 2A:10BC.
5. Home is equipped with a smoke/carbon monoxide detector. The smoke/carbon monoxide detector was tested at the time of visit and observed to be operational.

Pg. 2 of 3

SUPERVISORS NAME: Rita Ramos
LICENSING EVALUATOR NAME: Joe Katrdzhyan
LICENSING EVALUATOR SIGNATURE:	DATE: 08/22/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/22/2024

LIC809 (FAS) - (06/04)

Page: 2 of 3

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: ADAMIAN FAMILY CHILD CARE	FACILITY NUMBER: 195700286
	VISIT DATE: 08/22/2024

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
26
27
28
29
30
31
32

6. Applicant stated that a cell phone with active service in the home will be the main contact number while children are in care.
7. All poisons, detergents, cleaning compounds, medications, etc. are inaccessible to children or are locked.
8. Hazardous materials are inaccessible and kept out of the reach of children.
9. According to the Applicant, there are no weapons or firearms in the home. None were observed by LPA.
10. Outdoor play area is free from defects or dangerous conditions.
11. Outdoor area is fenced/enclosed.
12. Home does not have a swimming pool. LPA observed no bodies of waters.
13. Toys and play items are safe, clean, and appropriate for the ages of the children.
14. Applicant agrees that baby-walkers, bouncers, jumpers, and similar items will not be used for children in care and are kept inaccessible.
15. The home is equipped with a first-aid kit equipped with, cleansing pads, healing ointment, bandages, gauze, and a digital thermometer.
16. The home is equipped with a central air conditioning and heating system, which can be adjusted using a thermostat.
17. The washer and dryer are located inside bathroom 2.

An exit interview was conducted and report was reviewed with Applicant / Ani Adamian.

A copy of this report was provided to the Applicant. Final license determination will be made upon review by the Licensing Program Manager. There were no corrections requested during this visit.

Pg. 3 of 3

SUPERVISORS NAME: Rita Ramos
LICENSING EVALUATOR NAME: Joe Katrdzhyan
LICENSING EVALUATOR SIGNATURE:	DATE: 08/22/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/22/2024

LIC809 (FAS) - (06/04)

Page: 3 of 3