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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 195700329
Report Date: 10/03/2024
Date Signed: 10/03/2024 04:12:39 PM

Document Has Been Signed on 10/03/2024 04:12 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:MAMULIAN FAMILY CHILD CAREFACILITY NUMBER:
195700329
ADMINISTRATOR/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
10/03/2024
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:10 PM
MET WITH:Marianna Mamulian, ApplicantTIME VISIT/
INSPECTION COMPLETED:
04:30 PM
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On 10/03/2024, beginning at 01:10 PM, Licensing Program Analyst (LPA) Elicia Calvillo conducted an announced Pre-Licensing inspection at 17163 Ludlow Street, Granada Hills, CA 91344. Applicant is applying for a small Family Child Care Home, anticipating caring for 8 children from ages birth to 13 years of age. The Applicant’s current proposed hours of operation are Monday through Friday 08:00 AM - 05:30 PM. LPA met with Marianna Mamulian, Applicant, who guided LPA on a tour of the inside and outside of the home. There were 4 adults and 4 children present who reside in the home.

Because the Applicant leases the home, proof of landlord notification is required. The LPA observed the Property Owner/Landlord Notification form (LIC 9151) that the Applicant confirms was provided to the property owner/landlord. The Applicant obtained a signed Property Owner/Landlord Consent form (LIC 9149).

As drawn on the facility sketch and observed during the tour, the facility is a one-story residence consisting of a living room, family/dining room, kitchen, 3 bedrooms, 2 bathrooms, laundry room and attached garage. There is a fenced 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. Behind the play area there an ADU with address 17165 Ludlow Street, Granada Hills, CA 91344.

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SUPERVISORS NAME: Rita Ramos
LICENSING EVALUATOR NAME: Elicia Calvillo
LICENSING EVALUATOR SIGNATURE: DATE: 10/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/03/2024
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: MAMULIAN FAMILY CHILD CARE
FACILITY NUMBER: 195700329
VISIT DATE: 10/03/2024
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LPA observed the following inside areas will be used for child care: living room, family/dining room, bedroom #1 and bathroom #1 will be used for child care activities. The living room will be used to isolate children with signs of an illness. The kitchen will be used as a pass through to the family/dining room and is made inaccessible with use of a child gate secured to the wall and child proof latches on the cabinets. The family/dining room will be used for play activities, eating and sleeping. LPA observed 5 chairs,1 table, 1 portable crib, 1 high chair, and 8 cots, applicant stated they will purchase 16 chairs, 2 tables, and bed linens. Bedroom #1 will be used for an infant sleeping room. LPA observed toys and play items that are safe, clean, and appropriate for the ages of the children.

Bathroom#1 located in hallway near the family/dining room will be used for children. The vanity cabinet holds paper products, cloth towels, and no hazards were observed. LPA observed that the bathroom that children will use was safe and sanitary.

Applicant stated that when a child shows signs of an illness the child will isolated in the living room. Applicant stated they will provide snacks and meals and understands if food is brought in by the parent the container will be labeled with the child’s name. There is telephone service via a cellphone that must remain in the facility during the hours of operation.



Each bedroom is equipped with a smoke detector, there is a smoke detector and carbon monoxide detector in the hallway near bathroom #1; all were tested and are operable.

There is a working fire extinguisher, the valve on the required 3A:40BC fire extinguisher indicates fully charged and was serviced on 05/20/2023.

LPA reviewed with Applicant that fire extinguisher type 3A:40BC must be serviced annually. LPA also indicated that the Fire Extinguisher 2A:10BC is required. Smoke and carbon monoxide detectors should be checked periodically, and batteries should be replaced.

LPA reviewed with 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.

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SUPERVISORS NAME: Rita Ramos
LICENSING EVALUATOR NAME: Elicia Calvillo
LICENSING EVALUATOR SIGNATURE:

DATE: 10/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/03/2024
LIC809 (FAS) - (06/04)
Page: 2 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: MAMULIAN FAMILY CHILD CARE
FACILITY NUMBER: 195700329
VISIT DATE: 10/03/2024
NARRATIVE
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There is adequate central heating and ventilation for safety and comfort. LPA did observe a fireplace with glass doors to enclose and was made inaccessible with the use of a child proof latch. LPA did not observe an open face heater.

The back yard can be accessed from family/dining room sliding door and Applicant will install a child proof lock on the door. There is a Sun Room that is fully enclosed and will be used as a play area. LPA observed toys, equipment, and other play items that are safe and appropriate for the ages of the children. The outdoor play area can be accessed from the Sun Room is accessible to children is covered with cement, artificial grass and is fenced. LPA observed outdoor toys and other play items to play with that are safe and appropriate for the ages of the children. LPA observed a side yard that is inaccessible to children with the used of 2 gates. LPA did not observe any objects that can pose a danger to children on the outdoor play yard. LPA observed an ADU. Applicant will submit an updated Facility Sketch -Yard to include the location of the ADU and address. LPA observed there is a separate entrance to the ADU and the gate is secured on the applicant’s side of the fence with the use of a lock.

LPA observed the following inside areas are not used for child care; kitchen, bedroom #1, bedroom #3, bathroom #2, laundry room, and attached garage. Applicant has made the areas inaccessible to children with the use of baby gates, child proof locks, and door locks.

Detergents, cleaning compounds, medications, and other items which could pose a danger to children were observed to be inaccessible to children. The licensee states that there are no poisons in the home and understands that storage areas for poisons must be locked with a key or combination lock.

Per Applicant, there are no firearm or other weapons on the premises and LPA did not observe any firearms or weapons on the premises during the inspection.

Per Applicant there are no pets on the premises and LPA did not observe any pets on the premises.

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SUPERVISORS NAME: Rita Ramos
LICENSING EVALUATOR NAME: Elicia Calvillo
LICENSING EVALUATOR SIGNATURE:

DATE: 10/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/03/2024
LIC809 (FAS) - (06/04)
Page: 3 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: MAMULIAN FAMILY CHILD CARE
FACILITY NUMBER: 195700329
VISIT DATE: 10/03/2024
NARRATIVE
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LPA did not observe any pools, spas, hot tubs, fish ponds, or similar bodies of water during the inspection.

LPA reviewed with Applicant that children eating may only be in highchairs and that car seats are utilized only for transportation.

LPA reviewed with Applicant that regulation prohibits smoking in a private residence licensed as a family child care home. Per Applicant, no one smokes in the home.

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.



LPA reviewed with Applicant reporting and notification requirements for any unusual incident or injury to the Child Care Regional Office by telephone within 24 hours and within 7 days complete a written report, LIC 624B Unusual Incident/Injury Report.

The Applicant has completed training on preventive health practices including Pediatric First Aid and CPR. The Applicant's Pediatric First Aid and CPR expires on 01/2025. There are first aid supplies available. The Applicant does have proof of immunization against influenza, pertussis, and measles. The Applicant does have proof of the Mandated Reporter AB 1207 compliant Child Care Training Certificate.

Criminal Record Clearance - Family Child Care Homes Marianne Mamulian, 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.



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SUPERVISORS NAME: Rita Ramos
LICENSING EVALUATOR NAME: Elicia Calvillo
LICENSING EVALUATOR SIGNATURE:

DATE: 10/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/03/2024
LIC809 (FAS) - (06/04)
Page: 4 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: MAMULIAN FAMILY CHILD CARE
FACILITY NUMBER: 195700329
VISIT DATE: 10/03/2024
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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 http://www.cpsc.gov and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

LPA did not observe the following items during the inspection: Infant Walkers, Johnny Jumpers, Saucer Chairs, Trampolines and/or any other item that fall into these categories are not permitted in a family child care facility.

LPA reviewed with Applicant that applicant shall be present in the home and shall ensure that children in care are supervised at all times. Applicant was 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.

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.

Applicant 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.



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SUPERVISORS NAME: Rita Ramos
LICENSING EVALUATOR NAME: Elicia Calvillo
LICENSING EVALUATOR SIGNATURE:

DATE: 10/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/03/2024
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: MAMULIAN FAMILY CHILD CARE
FACILITY NUMBER: 195700329
VISIT DATE: 10/03/2024
NARRATIVE
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On this date, 06/17/2024, 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.

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.



The following list of corrections needs to be completed prior to licensure approval:
Purchase 16 chairs and 2 tables.
Update Facility Sketch -Yard to show the ADU location (to facility), address, and off-limits.
Family/Dining room sliding door needs a child proof lock.

Applicant to correct the above issues by 10/21//2024.

Exit interview conducted and report was reviewed with Marianna Mamulian, Applicant.

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SUPERVISORS NAME: Rita Ramos
LICENSING EVALUATOR NAME: Elicia Calvillo
LICENSING EVALUATOR SIGNATURE:

DATE: 10/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/03/2024
LIC809 (FAS) - (06/04)
Page: 6 of 6