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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197494775
Report Date: 10/25/2021
Date Signed: 10/25/2021 06:58:29 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
This is an official report of an unannounced visit/investigation of a complaint received in our office on
09/24/2021 and conducted by Evaluator Antonio Almanza
PUBLIC
COMPLAINT CONTROL NUMBER: 30-CC-20210924090814
FACILITY NAME:HOVHANNESYAN FAMILY CHILD CAREFACILITY NUMBER:
197494775
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 2DATE:
10/25/2021
UNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Licensee SHUSHANIK HOVHANNESYANTIME COMPLETED:
11:55 AM
ALLEGATION(S):
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Allegation: Licensee administered medication without parent’s consent.
Allegation: Licensee failed to meet children's needs.

***Amended Report to capture Signature.
INVESTIGATION FINDINGS:
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On October 25, 2021 at 11:30 am, Antonio Almanza, Licensing Program Analyst (LPA), conducted an unannounced site visit for the purpose of delivering findings for complaint received on September 24, 2021. LPA met with SHUSHANIK HOVHANNESYAN, Licensee, and explained the purpose of the visit.

During the Complaint investigation, interviews were conducted, observations were made, and records were reviewed regarding the aforementioned allegations.

The complaint allegations received by the department against the facility allege that the Licensee gave medication to children in care without the guardian’s consent and that the licensee leaves the children in the home with another adult.

Pg 1.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Mary Ruiz
LICENSING EVALUATOR NAME: Antonio Almanza
LICENSING EVALUATOR SIGNATURE:

DATE: 10/25/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/25/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 2
Control Number 30-CC-20210924090814
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION 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: HOVHANNESYAN FAMILY CHILD CARE
FACILITY NUMBER: 197494775
VISIT DATE: 10/25/2021
NARRATIVE
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The guardian of the children whom were allegedly given medication is reporting that the licensee has never given medication to the children. The guardian is also reporting that the child care is wonderful and is proud of taking children there. The guardian reports that is very happy with the child care and that they do everything per code, and nothing is out of the ordinary. LPA conducted a visit at the facility and did not observe the medications that were allegedly given to children in care. The Licensee and her assistant are reporting that the facility does not give children medication and if a child becomes ill while in care the parents are contacted to pick up their children.

Although the allegations may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegation is unsubstantiated.

A copy of this Report, Appeal Rights, and Notice of Site Visit were explained and provided to the Licensee SHUSHANIK HOVHANNESYAN. Licensees Sister translated in Armenian for the Licensee.
SUPERVISORS NAME: Mary Ruiz
LICENSING EVALUATOR NAME: Antonio Almanza
LICENSING EVALUATOR SIGNATURE:

DATE: 10/25/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/25/2021
LIC9099 (FAS) - (06/04)
Page: 2 of 2