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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197494319
Report Date: 05/05/2022
Date Signed: 05/05/2022 11:51:30 AM

Document Has Been Signed on 05/05/2022 11:51 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
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:OGANESYAN FAMILY CHILD CAREFACILITY NUMBER:
197494319
ADMINISTRATOR:ANAHIT OGANESYANFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(818) 468-9433
CITY:VALLEY GLENSTATE: CAZIP CODE:
91401
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 1DATE:
05/05/2022
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
10:40 AM
MET WITH:Licensee Anahit OganesyanTIME COMPLETED:
12:00 PM
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On 05/05/2022 at 10:00 AM, Licensing Program Analyst (LPA) Sabrina Martinez conducted a case management visit at Oganesyan Family Child Care Home for the purpose of investigating the incident that occurred at the facility on 04/22/2022.

The Department received the Unusual Incident Report via phone call on 04/25/2022. According to the report, on 04/22/2022, at approximately 05:30 PM, licensee’s husband attempted to put leash on the dog. The dog started barking and the leash slipped and the dog bit Child’s hand and back. The child had puncture wounds on left hand and back. Licensee stated she put ice and placed alcohol on wounds. Licensee contacted the Child’s mother and child was taken to the hospital.

During this visit, LPA observed 1 child being supervised by licensee. LPA interviewed licensee and obtained the following documents: Licensee's Written Declaration Form, Child Care Facility Roster (LIC 9040) and vaccination records for the French Bulldog and Chihuahua Mix. LPA also toured the backyard and other areas that are accessible to day care children.

At this time, further investigation is needed.

An exit interview was conducted and a copy of this report and Notice of Site Visit were provided to Licensee Anahit Oganesyan. w
SUPERVISORS NAME: Maureen Neal
LICENSING EVALUATOR NAME: Sabrina Martinez
LICENSING EVALUATOR SIGNATURE: DATE: 05/05/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/05/2022
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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