197494252-9-28-2021-30-CC-AALA-C7ARVL-20210928132143

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197494252
Report Date: 09/28/2021
Date Signed: 09/28/2021 01:21:53 PM

Document Has Been Signed on 09/28/2021 01:21 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
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME:	ISAYAN FAMILY CHILD CARE		FACILITY NUMBER:	197494252
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 0	CENSUS: 6	DATE:	09/28/2021
TYPE OF VISIT:	Case Management - Other	UNANNOUNCED	TIME BEGAN:	11:55 AM
MET WITH:	Jenny Isayan		TIME COMPLETED:	01:35 PM

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	On 09/28/2021 at 11:55 am, Licensing Program Analyst (LPA) Antonio Almanza conducted an announced Increase in capacity Inspection and met with the Licensee Jenny Isayan who guided LPA on a tour of the home inside and out. The applicant is applying for a Large Family Child Care License to operate Monday through Friday from 7:00 am to 6:00 pm and serve children ages 1 year to 12 years of age. The single-story home is a 3 bedroom, 2 bathroom home with detached garage located on the South West corner of Vanowen St and Katherine Ave. The home will be entered by parents from the front entrance on Katherine ST through rought iron gate. Fire Clearance was granted on 09/16/2021. There is no Pull-Down Fire Alarm in the facility. Present in the home is the Licensee and her assistant. The Licensee states the main care will be provided in the Living room, dinning room, and 2 bedrooms located in the back of the home, children will use the bathroom in the hallway on the right side of the home. The off-limits areas of the home are as follows: kitchen, laundry room, Licensee bedroom, and bathroom located across from the kitchen. Licensee will provide meals and snacks to children in care. Licensee will use a cell phone for the family child care home and was advised that the cell phone should remain in the home while children are in care. LPA observed age appropriate toys, 13 cots and 3 cribs and 2 playpens. LPA did not observe any hazards for children in care. There is a fully equipped 2A10BC fire extinguisher and first aid kit located in the kitchen. The Licensee places all sharp items/knifes and medication in top laundry room shelf. LPA observed required postings. LPA observed an operating Smoke and CO detector in the living room. Cleaning supplies are kept under the kitchen sink. Licensee stated there are no weapons or firearms in the home and LPA did not observe any. The back yard will be used for children in care. There is a covered area with artificial turf for children to play in there is a detached garage that is inaccessible and used for storage by the property owner. There are age appropriate toys for children to play with. Pg 1.

SUPERVISORS NAME: Mary Ruiz
LICENSING EVALUATOR NAME: Antonio Almanza
LICENSING EVALUATOR SIGNATURE:	DATE: 09/28/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/28/2021

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 3

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: ISAYAN FAMILY CHILD CARE	FACILITY NUMBER: 197494252
	VISIT DATE: 09/28/2021

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 following was discussed with the applicant:
-Individuals who are 18 years of age or older living in the home must obtain a criminal record clearance. Individuals within one month of their 18th birthday must be fingerprinted immediately. If the aforementioned is not adhered to, a Civil Penalty of up to $500, per non-cleared adult will be assessed immediately. Please advise your analyst of any person who will be visiting regularly or for longer than one week. -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.
-Commencing September 1, 2016, a person shall not be employed or volunteer at a family day care home if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year. The family day care home shall maintain documentation of the required immunization's or exemptions from immunization, as set forth in this section, in the person’s personnel record that is maintained by the family day care home. -A current roster of children enrolled must be available and maintained for a period of three years, even after children no longer are attending the facility.
-Annual fees must be paid promptly and by the due date or a late fee shall be assessed, and/or the License shall be terminated. -The fire extinguisher type 2A-10BC must be serviced annually. Smoke and carbon monoxide detectors should be checked, and batteries should be replaced. -Changes should be reported the to the Department as soon as they occur such as construction and remodeling. -Telephone number changes and/or if you move from home. -Any unusual incidents or injuries must be reported to the Department within 24 hours via telephone and within seven (7) days in writing. -Fire and safety drills must be performed every six months and documented for review by the Department. -The smoking of tobacco in a private residence that is licensed as a family child care home shall be prohibited and in those areas of the family day care home where children are present.
- Children and Staff records must be maintained and updated as needed and must be available for review by the Department. -Saucer chairs, bouncers, walkers, or any similar items are prohibited. -All adults living and working in the home shall be made of aware of the Departments right to inspection authority, which includes but not limited to the right to enter the home when children are being cared for, interview children and adults and review documentation. -LPA advised the applicant how to access forms, regulations and quarterly updates on the Child Care Licensing website at: www.ccld.ca.gov.
Pg 2.

SUPERVISORS NAME: Mary Ruiz
LICENSING EVALUATOR NAME: Antonio Almanza
LICENSING EVALUATOR SIGNATURE:	DATE: 09/28/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/28/2021

LIC809 (FAS) - (06/04)

Page: 3 of 3

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: ISAYAN FAMILY CHILD CARE	FACILITY NUMBER: 197494252
	VISIT DATE: 09/28/2021

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

Safe Sleep Links:
AAP:https://www.healthychildren.org/English/ages-stages/baby/sleep/Pages/A-Parents-Guide-to-Safe-Sleep.aspx
NIH: https://safetosleep.nichd.nih.gov/safesleepbasics/environment/room/text_alternative Safe to Sleep Campaign: https://safetosleep.nichd.nih.gov/materials, PIN 20-24-CCP: Recently Approved Safe Sleep Regulations In Effect. PIN 20-24-CCP: Recently Approved Safe Sleep Regulations In Effect

Incidental Medical Services: 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 Incidental Medical Services Include: Blood-Glucose Monitoring for Diabetic Children, Administering Inhaled Medication, Administering EpiPen Jr. and EpiPen or other Epinephrine Auto-Injectors, Glucagon Administration, Gastrostomy Tube Care (G-tube care), Insulin Injections Administration, Anti-Seizure Administration, and Emptying an Ileostomy Bag.

The following is needed prior to approval for licensure.

1. Remove bricks and cover electric outlet that is in the middle of the yard.

2. LPA to verify that all required documents are on file.

3. Licensure approval by Licensing Program Manager.

An Exit Interview was conducted, and a copy of this report and notice of site visit was provided to the applicant Jenny Isayan.

SUPERVISORS NAME: Mary Ruiz
LICENSING EVALUATOR NAME: Antonio Almanza
LICENSING EVALUATOR SIGNATURE:	DATE: 09/28/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/28/2021

LIC809 (FAS) - (06/04)

Page: 2 of 3