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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 195700339
Report Date: 01/08/2025
Date Signed: 01/08/2025 01:32:18 PM

Document Has Been Signed on 01/08/2025 01:32 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:GRIGORYAN FAMILY CHILD CAREFACILITY NUMBER:
195700339
ADMINISTRATOR/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
01/08/2025
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:02 AM
MET WITH:AREVIK GRIGORYANTIME VISIT/
INSPECTION COMPLETED:
12:20 PM
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On 1/8/2024, Licensing Program Analyst (LPA) Suzette Ornelas conducted an announced Pre-Licensing Inspection at 6733 VARNA AVE VAN NUYS CA 91401. 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, AREVIK GRIGORYAN. This is an application for a Small Family Child Care Home, 8 children-ages 4 years to 16 years of age. The family child care home will operate Monday through Friday 8:30 a.m. to 4:30 p.m. Applicant, AREVIK GRIGORYAN, guided LPA on a tour of the inside and outside of the home. LPAs observed 3 adults and 0 child in care.

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 with the living room (day care area), kitchen, 1 restrooms located in the hallway, 3 bedrooms and a second bathroom located inside and bedroom 3. LPA observed the following:
· The living room (day care area) is on-limits and will be used for child care activities.
· Restroom located in the hallway is on-limits and accessible to children in care.
· Bedroom 1 (day care area )is on-limits and accessible to children in care.
· The kitchen is off-limits and is made inaccessible from the day care area by sliding doors and supervision. Kitchen cabinet and drawers containing hazardous materials and sharp objects are made inaccessible by safety latches and locks.
· Bedroom 2 is off-limits and is inaccessible to children in care by the use of a locked door.
· Bedroom 3 is off-limits and is inaccessible to children in care by the use of a locked door. Bathroom 2 is accessible from Bedroom 3 and off limits to children in care.
· Front and backyard are on limits to children in care. Home is gated for safety.
· Garage is of limits to children in care and made inaccessible by the use of a closed door.
SUPERVISORS NAME: Raul Navarro
LICENSING EVALUATOR NAME: Suzette Ornelas
LICENSING EVALUATOR SIGNATURE: DATE: 01/08/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/08/2025
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 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: GRIGORYAN FAMILY CHILD CARE
FACILITY NUMBER: 195700339
VISIT DATE: 01/08/2025
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The following was also observed by LPAs 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. 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 at least 2 working smoke alarm and a carbon monoxide detectors.


6.Home has a working telephone.
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.
10.Outdoor space is clean and free of hazards.
11.Outdoor area is gated.
12.Home does not have a swimming pool.
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.

The following was thoroughly discussed with the Applicant
· Applicant was made aware of The Child Care Advocate Program (CCAP) that is administered from within the Community Care Licensing Division. CCAP participates in many community activities and special projects in order to disseminate information on the State’s licensing role, provide information to the public and parents on child care licensing, and provide many other helpful resources to the licensees and the public. CCAP’s direct contact information is as followed: Phone number: (916) 654-1541.
Email Address: childcareadvocatesprogram@dss.ca.gov
SUPERVISORS NAME: Raul Navarro
LICENSING EVALUATOR NAME: Suzette Ornelas
LICENSING EVALUATOR SIGNATURE:

DATE: 01/08/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/08/2025
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: GRIGORYAN FAMILY CHILD CARE
FACILITY NUMBER: 195700339
VISIT DATE: 01/08/2025
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·Commencing September 1, 2016, SB 792, prohibits a person from being employed or volunteering at a child care facility or family day care if he or she has not been immunized against influenza, pertussis and measles. LPA discussed the influenza waiver during the inspection.

· Beginning on January 1, 2018, AB 1207, requires all licensed providers, applicants, directors and employees to complete training as specified on their mandated reporter duties and to renew their training every two years. Website: www.mandatedreporterca.com. Licensee was reminded of their responsibility to report suspected child abuse.

· Upon receipt by the licensee, licensees are to provide to parents/guardians the following: Copies of any licensing reports that document a Type A citation- this includes facility visits and substantiated complaint investigations; copy of licensing documents pertaining to a conference conducted by a local licensing agency management representative and the licensee of this family child care home in which issues of noncompliance are discussed or copies of a summary of an accusation indicating the Department's intent to revoke the facility's license. Copies of any of the above licensing documents the licensee has received in the prior 12 months shall be provided to parents/guardians of newly enrolled child at the facility. (AB) 633

· Applicant was advised that regulation prohibits the smoking of tobacco in a private residence licensed as a family child care home during the hours of operation.

· The fire extinguisher type 2A-10BC must be services annually or as often as necessary. Smoke and carbon monoxide detectors should be checked, and batteries should be replaced.

· A current roster of children enrolled must be maintained and available. 1596.841

· Applicant was reminded to report any unusual incidents or injuries to the Child Care Regional Office by telephone within 24 hours and in writing within 7 days.

· Applicant was reminded that all infants must be placed on their backs when sleeping to prevent S.I.D.S. (Sudden Infant Death Syndrome) and that the Provider is required to wash hands after every diaper change and to never shake a baby to prevent the Shaken Baby Syndrome. Safe to Sleep Campaign: https://safetosleep.nichd.nih.gov/materials19-02 CCP Safe Sleep Awareness Campaign
SUPERVISORS NAME: Raul Navarro
LICENSING EVALUATOR NAME: Suzette Ornelas
LICENSING EVALUATOR SIGNATURE:

DATE: 01/08/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/08/2025
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: GRIGORYAN FAMILY CHILD CARE
FACILITY NUMBER: 195700339
VISIT DATE: 01/08/2025
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·Applicant was reminded that only children eating may be in highchairs and that car seats are utilized only for transportation.

· Applicant was made aware that state law prohibits baby walkers, bouncy seats, exersaucers and any other items that fall into that category. 1596.846(b)(c)

· Applicant was reminded that it is the licensee’s, as well as anyone who assists in providing care, responsibility to know the regulations. Licensee was advised on how to access quarterly reports, forms, and regulations for Child Care online at www.ccld.ca.gov. Licensee was also encouraged to read the Child Care quarterly updates as they come out to stay informed of any changes or updates to statutes and regulations.


· In the absence of the licensee a qualified adult must be present supervising the children; a qualified adult is an individual who has a valid and current adult/infant CPR& Pediatric First Aid certification and a valid criminal record clearance associated to the facility license.

· Due to the COVID-19 pandemic and local and state ordinances, licensee was directed to the CCLD.CA.GOV website for important updates and PINS. Licensee was directed to PIN 22-10-CCP.



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.

Mortgage Bill on file for Applicant.
SUPERVISORS NAME: Raul Navarro
LICENSING EVALUATOR NAME: Suzette Ornelas
LICENSING EVALUATOR SIGNATURE:

DATE: 01/08/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/08/2025
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: GRIGORYAN FAMILY CHILD CARE
FACILITY NUMBER: 195700339
VISIT DATE: 01/08/2025
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On this date, 7/1/2024, 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.

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.

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.

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-care-licensing/subscribe and select the Child Care option to receive email communication
SUPERVISORS NAME: Raul Navarro
LICENSING EVALUATOR NAME: Suzette Ornelas
LICENSING EVALUATOR SIGNATURE:

DATE: 01/08/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/08/2025
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: GRIGORYAN FAMILY CHILD CARE
FACILITY NUMBER: 195700339
VISIT DATE: 01/08/2025
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Proof of corrections have been discussed with Applicant, including:
- Picture of Baby Gate in Backyard to ensure off limit area is inaccessible
- Picture of A/C cover in backyard
- Picture of front yard clear from excess grass turf
- Emergency backpack 3 day supply w/ flashlight and radio

Exit interview conducted and report was reviewed with the Applicant, AREVIK GRIGORYAN.

A copy of this report was provided to the Applicant. Final license determination will be made upon review by the Licensing Program Manager.
SUPERVISORS NAME: Raul Navarro
LICENSING EVALUATOR NAME: Suzette Ornelas
LICENSING EVALUATOR SIGNATURE:

DATE: 01/08/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/08/2025
LIC809 (FAS) - (06/04)
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