197494894-12-7-2022-58-CC-AALA-CLVVWJ-20221207154802

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197494894
Report Date: 12/07/2022
Date Signed: 12/07/2022 03:48:08 PM

Document Has Been Signed on 12/07/2022 03:48 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:	MELKONYAN & HOVHANNISYAN FAMILY CHILDCARE		FACILITY NUMBER:	197494894
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 6	CENSUS: 5	DATE:	12/07/2022
TYPE OF VISIT:	Case Management - Other	UNANNOUNCED	TIME BEGAN:	12:30 PM
MET WITH:			TIME COMPLETED:	03:58 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 12/07/2022, at 8:34 AM, Licensing Program Analyst (LPA), conducted an announced Increase in Capacity Inspection and was met by Licensee, Ghevond Melkonyan. Also present were Co-Licensee and Staff #1 (S1). Days and hours of operation are Monday through Friday from 7:00 AM to 6:00 PM. LPA verified facility phone number (Cell phone) is 818-926-8619; Licensee was reminded that when there are children in care the cell phone must remain in the facility. During todays visit there were 5 children in care. Co-Licensees and 2 minor children ages 3 and 8 years old live in the home. Fire Clearance was approved on 11/10/22. The Family Child Care home is located on the corner of Oakdale Ave and Strathern St. The home is entered on Strathern St. The home has a security gate with ring doorbell and visitors must be allowed inside by the Licensee. The home is a 5 bedroom 3 ½ bathroom, with detached garage. The rooms used for Children in care are located in the back of the home and are identified as Rooms 1, Room 2 and Room 3 on the facility Sketch. The Rooms start with room 1, with door that leads to room 2, with door that lead to room 3. Rooms 1 & 2 are used for activities and Room 3 is used for sleeping. Current facility sketch was reviewed and Licensee confirmed that Rooms 1, 2, 3 and bathroom inside Room 2 are used for providing care and supervision to children in care. All other rooms are off-limits and made inaccessible by use of child safety locks and child safety gate. Licensee was adviced that Firearms and ammunition are stored and locked in separate locations. All poisons are kept in a locked storage area inaccessible to children in care. Detergents, cleaning compounds, medication and other hazardous items are made inaccessible to children in care. Pg 1 of 3

SUPERVISORS NAME: Betty Bell
LICENSING EVALUATOR NAME: Antonio Almanza
LICENSING EVALUATOR SIGNATURE:	DATE: 12/07/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/07/2022

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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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: MELKONYAN & HOVHANNISYAN FAMILY CHILDCARE	FACILITY NUMBER: 197494894
	VISIT DATE: 12/07/2022

NARRATIVE

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There are no fireplaces or open face heaters in the home. There is a fire extinguisher located in the pantry next to Room one; LPA is unable to verify when it was purchased or serviced within one year. There are working combination smoke detector/carbon monoxide detector located in the Laundry room inside of room 2, and kitchen. There is a First Aid Kit located in the kitchen. The home has central air to provide adequate heating and ventilation for safety and comfort. There are no stairs in this home. Licensee was provided Prohibited Items In Child Care Homes Flyer.

There is currently one infants in care (Child 2/C2). LPA discussed Safe Sleep Regulations with licensee. There is one crib or play yard for each infant in care, cribs and play yards are kept free from all loose articles and objects while infants are sleeping, and there are no objects hanging above or attached to the crib or play yard. Infants shall not swaddled while in care. Provider was advised that staff shall physically checks on sleeping infants every fifteen minutes and documents any signs of distress which includes but is not limited to flushed skin color, increase in body temperature, restlessness and labored breathing. Infants shall be visually observed through an open door if sleeping in a separate room. Individual Infant Sleeping Plan shall be completed and in file for each infant up to 12 months of age. Infants up to 12 months of age are placed on their backs for sleeping.

Licensee was informed that children must be supervised at all times and is aware children shall not be left in parked vehicles. Car seats are used for transportation purposes only and are not used for sleeping children. The outdoor play area in the backyard is fenced and there are no hazards to children present. There is a large tree that provides shade to children. There is artificial turf in the backyard. There is large dog in the home that is maintained in areas that are not accessible to children in care. Capacity as specified on the license is being maintained.

Incidental Medical Services (IMS) are currently being provided. Licensee is aware that an IMS plan is required to be submitted to the licensing office if they provide any of these services. Information regarding Americans with Disability Act (ADA) can be obtained by contacting US Department of Justice toll free ADA Information line at (800) 514-0301(voice), (800) 514-0383 (TDD) and website link https://www.ada.gov/childqanda.htm.

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SUPERVISORS NAME: Betty Bell
LICENSING EVALUATOR NAME: Antonio Almanza
LICENSING EVALUATOR SIGNATURE:	DATE: 12/07/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/07/2022

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: MELKONYAN & HOVHANNISYAN FAMILY CHILDCARE	FACILITY NUMBER: 197494894
	VISIT DATE: 12/07/2022

NARRATIVE

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Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, 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 up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

LPA discussed the safe sleep regulations with licensee [or facility representative] 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 licensee [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.

LPA reviewed with the Licensee LIC311D the Forms/Records to be keep in your family child care homes, children’s forms/records, , facility forms/record’s, and information to be posted. LPA provided Licensee with LIC311D and provided copies of all accompanying documents.

Before the increase in capacity is granted the following is required and will be completed by 12/16/2022.
- Update Facility Sketch
- All corrections to Annual Inspection must be completed.
- LPA to verify all required documents are on file.
- Licensing Program Manger approval.

A notice of site visit was given and must remain posted for 30 days.

A copy of this Report, Notice of Site Visit, and Appeal Rights were explained and provided to Licensee, GHEVOND MELKONYAN.

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SUPERVISORS NAME: Betty Bell
LICENSING EVALUATOR NAME: Antonio Almanza
LICENSING EVALUATOR SIGNATURE:	DATE: 12/07/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/07/2022

LIC809 (FAS) - (06/04)

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