<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197405475
Report Date: 06/20/2024
Date Signed: 06/20/2024 11:06:27 AM

Document Has Been Signed on 06/20/2024 11:06 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:SIMIDIAN FAMILY CHILD CAREFACILITY NUMBER:
197405475
ADMINISTRATOR/
DIRECTOR:		VARDUI SIMIDIANFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(818) 203-5325
CITY:NORTH HOLLYWOODSTATE: CAZIP CODE:
91606
CAPACITY: 14TOTAL ENROLLED CHILDREN: 2CENSUS: 0DATE:
06/20/2024
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
07:30 AM
MET WITH:Vardui Simidian, LicenseeTIME VISIT/
INSPECTION COMPLETED:
11:05 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
Licensing Program Analyst (LPA) Silva Garibyan conducted an unannounced required inspection to the above facility on 06/20/2024. LPA arrived at the facility at 7:30 AM, met with Virginia Silva, Licensee who guided analyst on a tour of the facility. LPA provided Licensees with a copy of the LIC 125 Entrance Checklist to help facilitate the inspection. Facility operation hours are Monday to Friday from 07:00 AM 06:00PM. Present during today's inspection was Licensee only. No children were present at the time of the visit. Licensee provides services for children newborn to 12 years old. Family members residing in the home include four adults. All areas identified on the facility sketch were inspected. This is a single story 3 bedroom, 2 bathroom home with living room, dining room, kitchen, and laundry room. There is also a recreation room attached to the detached garage. There is a pool located in the back yard. The pool is enclosed on 2 sides by property walls. There is a 5 foot, white, wrought iron fence that encloses the remaining 2 sides of the pool. A small portion of the pool is enclosed by the wall of a recreation room that contains 1 large window with permanent safety bars. (Children do not have access to this room). The pool gate is located on the right side of the fence. The gate was tested and observed to be self-closing and self-latching; and also contains a key lock. The latch is within 6 inches of the top of the gate. Vertical beams were measured to be 4 inches apart. Horizontal beams were 45 inches apart. Page1
SUPERVISORS NAME: Betty Bell
LICENSING EVALUATOR NAME: Silva Garibyan
LICENSING EVALUATOR SIGNATURE: DATE: 06/20/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/20/2024
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 4
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: SIMIDIAN FAMILY CHILD CARE
FACILITY NUMBER: 197405475
VISIT DATE: 06/20/2024
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 bottom of the fence is mounted over concrete and the space between the bottom of the fence is no more than 4 inches. No furniture or items were positioned next to the fence that would render the pool fence to be climbable. The fence allows visibility of the pool. Parents and children use the side door to enter the play room/master bedroom. Main care is provided in the day care/master bedroom. Children have access to the bathroom accessible from the day care room. Licensee has a safety gate at the entrance of the play room to prevent children from accessing the off limit areas. The detached recreation room is off limits and is not accessible to children. . The LPA toured all areas used by children during this inspection. Licensee reports she has no firearms or weapons in the home. The bathroom was observed free of chemicals or toxic items that can pose danger to children in care. Children play in the front yard. LPA observed the yard to be clean, free of debris, and fully fenced. The First Aid kit was observed, and complete.
The living room was observed to have age appropriate toys. three children size tables, 12 chairs, a play yard, and 14 cots.
The licensees have completed the Mandated Reporter training on 06/20/2024. LPA also observed Licensee's current Pediatric CPR (Adult/Infant /Child) and Pediatric First Aid certifications (expire 06/15/2024).
The Fire Extinguisher (2A-10-BC) is mounted on the wall in the kitchen. There is a working smoke and Carbon Monoxide detectors located in the living room.
An emergency fire/disaster drill has been completed and documented within the last 6 months.
Licensee has the following documents posted in the FCCH; Facility License (LIC 203), Notification of Parents' Rights Poster (PUB 394), Emergency Disaster Plan (LIC610a). Child Care Facility Roster (LIC9040) on file. Page 2
SUPERVISORS NAME: Betty Bell
LICENSING EVALUATOR NAME: Silva Garibyan
LICENSING EVALUATOR SIGNATURE:

DATE: 06/20/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/20/2024
LIC809 (FAS) - (06/04)
Page: 2 of 4
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: SIMIDIAN FAMILY CHILD CARE
FACILITY NUMBER: 197405475
VISIT DATE: 06/20/2024
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
A review of the children's records was conducted and are found to have the following: LIC 627/Consent for Medical Treatment, LIC 700/ID and Emergency Information, LIC 995A/Parent's Rights, LIC995E/Caregiver Background Check, LIC 9150/Parent Notification, LIC 9212/Parent's Responsibilities, PM 286/Immunization Card. Licensee provides meals and snacks. LPA discussed food preparation, storage and ensuring a log and information regarding dietary restrictions and allergies are kept up to date.

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.

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.

Page 3
SUPERVISORS NAME: Betty Bell
LICENSING EVALUATOR NAME: Silva Garibyan
LICENSING EVALUATOR SIGNATURE:

DATE: 06/20/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/20/2024
LIC809 (FAS) - (06/04)
Page: 3 of 4
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: SIMIDIAN FAMILY CHILD CARE
FACILITY NUMBER: 197405475
VISIT DATE: 06/20/2024
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
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 [or facility representative] 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.

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/.

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.
During the exit interview, the licensee Vardui Simidian, confirmed that there are no Registered Sex Offenders living in the facility.
A notice of site visit was given and must remain posted for 30 days.
Exit interview conducted and report was reviewed with the licensee Vardui Simidian.

Page 4
SUPERVISORS NAME: Betty Bell
LICENSING EVALUATOR NAME: Silva Garibyan
LICENSING EVALUATOR SIGNATURE:

DATE: 06/20/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/20/2024
LIC809 (FAS) - (06/04)
Page: 4 of 4