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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197416983
Report Date: 01/29/2025
Date Signed: 01/29/2025 02:57:54 PM

Document Has Been Signed on 01/29/2025 02:57 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
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:MELIKSETYAN FAMILY CHILD CAREFACILITY NUMBER:
197416983
ADMINISTRATOR/
DIRECTOR:		MELIKSETYAN, NAIRAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(323) 206-7624
CITY:LOS ANGELESSTATE: CAZIP CODE:
90036
CAPACITY: 12TOTAL ENROLLED CHILDREN: 12CENSUS: 8DATE:
01/29/2025
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:00 PM
MET WITH:Licensee, Nira MelksetyanTIME VISIT/
INSPECTION COMPLETED:
03:15 PM
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On January 29, 2025, at 1:00 pm Licensing Program Analysts (LPA) Priscilla Ochoa conducted an unannounced annual inspection at the above facility. LPA was greeted by licensee, Naira Meliksetyan who guided LPA on a tour of the facility. Licensee’s spouse and was also present during the inspection. Per licensee there are 13 children enrolled and LPA observed 8 children in care with 2 staff. Hours of operation are Monday – Friday from 7:45 am to 6 pm.

Family members residing in the home is 1 adult who has criminal record clearance. There are no minor children residing in the home. This is a single-story home that consist of 2 bedrooms, 2 bathrooms, living room, dining room, kitchen, den and backyard which is fenced.

Off limit areas include 1 bedroom, 1 bathroom and kitchen.

Areas accessible to children in care are 1 bedroom, 1 bathroom, living room, dining room, den and back yard which is fenced.

At 1:10 pm, licensee guided LPA on a tour of the facility. Upon entrance of the front door, LPA inspected the living room area were multiple age-appropriate toys were displayed. LPA also observed licensing forms posted on the living room wall next to the window. The dining room was inspected next and observed a table with chairs and more age appropriate toys for children in care. LPA observed 2 open faced heaters on the floor in wall in the dining and living room, which were covered, making them not accessible to children in care. LPA was then guided through the hallway, where LPA passed through the kitchen and observed a baby gate making the kitchen inaccessible to children in care. Bedroom 1 was inspected and observed 7 children napping. Napping equipment in the form of cots were observed. Bedding was observed to be clean an orderly. Per licensee, bedding is given to parents every Friday for washing purposes. LPA then observed the bathroom that is located in bedroom 1 and is accessible to children. The bathroom was observed to be clean and orderly.

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SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Priscilla Ochoa
LICENSING EVALUATOR SIGNATURE: DATE: 01/29/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/29/2025
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: MELIKSETYAN FAMILY CHILD CARE
FACILITY NUMBER: 197416983
VISIT DATE: 01/29/2025
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There was no hazards observed that can pose a danger to children in care. The den area is right next to bedroom 1 and was inspected. LPA observed 1 child napping in the den area. LPA observed S2 sitting in the doorway of the den and bedroom, observing children while napping. In the den area LPA observed a children’s table with chairs. Licensee then guided LPA to the back year from the den and observed more age-appropriate toys for children in care. All areas were observed to be clean, orderly, comfortable, and well ventilated.

There are first aid supplies available. Per licensee, the facility provides all meals to daycare children. Per licensee the den is used as an isolation area when a child becomes ill, while parents are called to pick up their child. A cot is available in needed.

Licensee's poisons, detergent, cleaning compounds, medications and other items which could pose a danger to child are stored where they are inaccessible to children.

LPA observed a smoke/carbon monoxide detector in the dining room. LPA did not test detector as children were napping. A 2A-10BC fire extinguisher was observed in the kitchen with a purchased receipt of 1/04/2024. LPA explained and reminded to the licensee that fire extinguishers must be serviced or purchased yearly. There is a working telephone on site.

Per the licensee, there are no firearms, pets or bodies of water on the premises. Licensee does obtain current Pediatric First Aid and CPR certification which expired on 8/23/2026.

LPA conducted a children file review and deemed complete. LPA conducted staff file review and deemed not complete. LPA could not review S2 TB clearance documentation.

Licensee has completed mandated reporter training which expires 1/02/2026. All childcare employees must complete mandated reporter training within 30 days of hire and renew training every two years at www.mandatedreporterca.com

Per the licensee, fire and disaster drills are conducted monthly; last drill was conducted on 1/17/2025.

Licensee has the required documents posted in the FCCH; Facility License (LIC 203), Notification of Parents' Rights Poster (PUB 394) and Emergency Disaster Plan (LIC610a) to be posted

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SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Priscilla Ochoa
LICENSING EVALUATOR SIGNATURE:

DATE: 01/29/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/29/2025
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
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: MELIKSETYAN FAMILY CHILD CARE
FACILITY NUMBER: 197416983
VISIT DATE: 01/29/2025
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Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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: http://www.ada.gov/childqanda.htm

Licensee was advised of the requirement to report unusual incidents and/or injuries to the parent/guardian and Licensing within the time frame specified by the regulation and on the form LIC624B. The on Duty Worker is available for questions Monday through Friday at (323) 981-3350 from 8:00 AM - 5:00 PM.

The licensee was informed of the responsibility to report suspected Child Abuse by calling the Child Abuse Hot-line at 1-800-540-4000. Also call the CCL office and follow up with a written Unusual Incident/Injury Report (LIC 624B).

The licensee was informed that the presence of adults in the home without Criminal Record Clearance or Exemption will be cited and civil penalty assessed for $100 per day. The licensee may find additional information and forms on the DSS website at www.ccld.ca.gov including information on the Live Scan application (LIC 9163). Appointments can be made for Live Scan at 1-800-315-4507

The following was discussed with the licensee:


Capacity requirements, Roster requirements, Posting requirements, Documentation requirements for disaster drills (fire and earthquake). Mandatory Forms for the children’s files and provider’s files, and Safe Sleep Awareness. The role and responsibilities of being a mandated reporter were reviewed. Licensee was reminded that supervision is always required to children in care.

Licensee was made aware that it is their responsibility to know the regulations as well as anyone who assists in providing care. Licensee was advised that inaccessibility of hazards must be constantly reassessed depending on the children in care. Licensing must always have the facility’s phone number; if the phone number is changed, licensing must be notified.

Regulation prohibits the smoking of tobacco in a private residence that is licensed as a family childcare home and in those areas of the family day care home where children are present (24/7 ban). State law prohibits baby walkers, bouncy seats, exersaucers and any other items that fall into that category.

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SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Priscilla Ochoa
LICENSING EVALUATOR SIGNATURE:

DATE: 01/29/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/29/2025
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
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: MELIKSETYAN FAMILY CHILD CARE
FACILITY NUMBER: 197416983
VISIT DATE: 01/29/2025
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--Licensee was advised to visit the CCL website (www.ccld.ca.gov) to obtain updates of courses and updates/changes to the regulations.
-- Our Quarterly updates come out every 3 months they are also now in Spanish please log in to the CCLD website or you can email our advocates to have the quarterly updates send directly to your email. Child Care Advocates information: www.childcareadvocatesprogram@cdss.ca.gov

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-andresources/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.

Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain childcare by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

The licensee, Naira Meliksetyan confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

LPA provided consultation during inspection.

Based on the LPA’s observations and record review, the following deficiencies listed on the attached LIC 809D (deficiency page) are being cited in accordance with California Code of Regulations Title 22. Deficiencies that are being cited need to be cleared to protect the children’s health and safety.

A notice of site visit was given and must remain posted for 30 days during facility’s hours of operation. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

An exit interview was conducted, and a copy of the report was provided to licensee, Naira Meliksetyan.

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SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Priscilla Ochoa
LICENSING EVALUATOR SIGNATURE:

DATE: 01/29/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/29/2025
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 01/29/2025 02:57 PM - It Cannot Be Edited


Created By: Priscilla Ochoa On 01/29/2025 at 02:37 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: MELIKSETYAN FAMILY CHILD CARE
FACILITY NUMBER: 197416983

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/29/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102417(g)(1)
Operation of A Family Child Care Home
(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (1) Fireplaces and open face heaters shall be screened to prevent access by children. The home shall contain a fire extinguisher and smoke detector device which meet standards established by the State Fire Marshall.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, interview, and record review, the licensee did not comply with the section cited above as fire extinguisher provided in the home was pruchased more than one year ago, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 02/03/2025
Plan of Correction
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Licensee will purchase a new 2A-10BC fire extinguisher and provide proof of purchase to LPA P. Ochoa by POC date of 2/02/2025
Type B
Section Cited
CCR
102369(9)
Evidence of a current tuberculosis clearance, not more than one year prior to or seven days after initial presence in the home, for any adult in the home during the time that children are under care.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on (record review), the licensee did not comply with the section cited above as spouse does not have proof of tuberculosis clearance, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 02/28/2025
Plan of Correction
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Licensee will have spouse obtain tuberculosis clearance and provide proof to LPA P. Ochoa by POC date 2/28/2025
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Ana Chico
LICENSING EVALUATOR NAME:Priscilla Ochoa
LICENSING EVALUATOR SIGNATURE:
DATE: 01/29/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/29/2025


LIC809 (FAS) - (06/04)
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