197418984-8-4-2023-58-CC-JLAO-CUDVQ4-20230804163744

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197418984
Report Date: 07/19/2023
Date Signed: 08/04/2023 04:37:57 PM

Document Has Been Signed on 08/04/2023 04:37 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:	KALYAN FAMILY CHILD CARE		FACILITY NUMBER:	197418984
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 8	CENSUS: 5	DATE:	07/19/2023
TYPE OF VISIT:	Case Management - Licensee Initiated	ANNOUNCED	TIME BEGAN:	02:01 PM
MET WITH:	Astgik Kalyan		TIME COMPLETED:	03:30 PM

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On 7/19/ 2023 Licensing Program Analyst (LPA) Judy Laureano conducted an announced inspection with applicant Astgik Kalyan Salyan for the purpose of a pre licensing inspection of an increase of capacity of 6302 Farmdale Avenue, North Hollywood, CA 91606. The purpose of this inspection is to ensure the standards for a Family Child Care Home are being met in accordance with California Tittle 22 Regulations and California Health and Safety Codes. Present during today’s inspection was licensee who was providing care and supervision to 5 children.

Per the application, at this time, the ages the applicant wishes to provide services for are children 2 months old to 12 years old, Monday- Sunday from 8:00 am to 12:00 a.m. Applicant is available to care for children seven days a week. Facility has been licensed for a Small Family Child Care Home with a max capacity of 8 as of 6/28/2013. Applicant currently has children attending care from 8 am to 6:00 p.m and does not have any child under the age of 12 months attending program.

Fire clearance was received and completed by inspector Shawn Connolly on 6/23/2023.

Applicant was informed that any changes to ages, hours and days of operation shall be submitted to the department for approval prior to initiation of changes. Applicant is applying for a Large Family Child Care License with a max capacity of 14. Copy of mortgage statement is on file. Applicant owns the property. Living in the home is applicant with two adult daughters.

LPA toured the home inside and outside. The facility is a single family home with 3 bedrooms, 2 bathrooms, a living room, dining room and kitchen area. The home has an enclosed front yard and back yard.

SUPERVISORS NAME: Claudia Escobedo
LICENSING EVALUATOR NAME: Judy Laureano
LICENSING EVALUATOR SIGNATURE:	DATE: 07/19/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/19/2023

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: KALYAN FAMILY CHILD CARE	FACILITY NUMBER: 197418984
	VISIT DATE: 07/19/2023

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Parents will access the home through the side of the home. Parents will enter through a gate that leads to the side and back yard. You enter the day care space though the sliding door. Once you enter the bedroom, closest to the kitchen, you are in the day care space. LPA observed age appropriate toys and materials. Children size cubbies where children store their personal belongings and a variety of children’s books. Child size table and chairs were observed in the space. LPA observed a parent board with all necessary posting. The space was observed to have a closet that is used to store the napping cots children use. Applicant confirmed children will nap and eat in the space.

Next to the space, the bathroom that children use was observed. A toilet, sink and shower were observed. All cabinets were observed to have safety latches making any content stored under the sink, inaccessible to the children in care.

Kitchen was observed and inspected. Kitchen is OFF LIMITS to the children in care. LPA observed stove knob covers on the stove and all kitchen cabinets were observed to have safety latches. Refrigerator, stove and counter space were observed and inspected. Knives and sharp objects were observed in a latched drawer- inaccessible to the children in care. Under the sink cabinet was observed with a safety latch, making the content inaccessible to the children in care. LPA observed a mounted fire extinguisher in the kitchen area. LPA discussed the importance of having policies in place to ensure that all who help with care and supervision are aware of any dietary restrictions and/or allergies. LPA also encouraged applicants to contact their local Resource and Referral agency, CCRC, to inquiry about any food programs.

LPA observed smoke detectors in all the rooms of the home and observed all electrical outlets in the home covered.

Next to the kitchen LPA observed the dining room and living room area. All areas are designated as OFF LIMITS to the children in care. The bedroom/day care room has a door that remains close when children are present making the rest of the home OFF LIMITS. LPA observed a barricaded fire place in the living room area.

Next to the living room/dining room area, LPA observed a small hallway that leads to bedroom 1, bedroom 2 and bathroom. All areas have been designated as OFF LIMITS and LPA reminded applicant that any area designated as OFF LIMITS, doors need to be closed and locked during the hours of operation and/or while children are present.

SUPERVISORS NAME: Claudia Escobedo
LICENSING EVALUATOR NAME: Judy Laureano
LICENSING EVALUATOR SIGNATURE:	DATE: 07/19/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/19/2023

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: KALYAN FAMILY CHILD CARE	FACILITY NUMBER: 197418984
	VISIT DATE: 07/19/2023

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The outdoor area was inspected and observed. LPA observed a covered patio where children are able to ride their bicycles. The space was also observed to have a wooden play structure with soft cushioning at the bottom of the slides.

The following area are designated as OFF LIMITS:
1. Main entrance of the home. Families enter the home through the side door.
2. Bedroom 1, bedroom 2 and bathroom. Living room with barricaded fire place and dining room area.

No corrections were needed during today’s inspection. Exit interview was conducted with applicant Astgik Kalyan. The licensing determination of this application will be reviewed with Licensing Program Manager for final resolution.

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.

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. PIN 22-05-CCP Page Eight

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, 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.

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.

SUPERVISORS NAME: Claudia Escobedo
LICENSING EVALUATOR NAME: Judy Laureano
LICENSING EVALUATOR SIGNATURE:	DATE: 07/19/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/19/2023

LIC809 (FAS) - (06/04)

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