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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197494694
Report Date: 01/10/2023
Date Signed: 01/10/2023 10:00:31 AM

Document Has Been Signed on 01/10/2023 10:00 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:MIRZOYAN FAMILY CHILD CAREFACILITY NUMBER:
197494694
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 4DATE:
01/10/2023
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
08:19 AM
MET WITH:MIRZOYAN, LUSINE -LicenseeTIME COMPLETED:
10:30 AM
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On 1/10/2023 at 8:20am Licensing Program Analyst Suzette Ornelas arrived to the Mirzoyan Family Child Care Home for a capacity increase inspection for a large family child care. LPA met with licensee Lusine Mirzoyan who will serve children ages 1-12 years old, Monday through Friday 7am-7pm. Fire Clearance STD 850 was GRANTED on 12/08/2022

LPA Ornelas completed a tour of the home inside and outside. Home is equipped with a security camera system. Home is found to be in substantial compliance. The main day care area located in the living room is on limits to children in care and will be used for child care activities and napping. Bedroom 3 is on limits to children in care and will be used for napping and child care activities. The restroom located in the hallway is on limits to children in care. The outdoor play area "deck day care" is on limits to children in care and will be used when children play outdoors. All other rooms are off limits to children in care by the use of closed doors and door knob safety covers. The facility is spacious enough to fit 14 children. There are substantial toys and equipment for the increase in children.

A records file review of children present and licensee was conducted and all required forms are present including required licensing posted forms. The licensee will increase capacity for 14 children and a flyer was given to show how many children and their ages can be admitted to care. LPA provided licensee with information on infant safe sleep along with informative flyers, safe sleep log, safe sleep regulation and . frequently asked questions. LPA also provided licensee with LIC311D -forms/records to keep at your family child care home and the Family Child Care Home Entrance Checklist, to ensure files are maintained up to date. LPA reminded licensee to ensure the fire extinguisher is serviced yearly and has either purchase receipt or service tag readily available.

A copy of this report was emailed to the licensee with instruction keep for personal records. LPA will recommend facility is ready for license to LPM.
SUPERVISORS NAME: Lisa Rios
LICENSING EVALUATOR NAME: Suzette Ornelas
LICENSING EVALUATOR SIGNATURE: DATE: 01/10/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/10/2023
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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