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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197495000
Report Date: 12/30/2021
Date Signed: 12/30/2021 03:12:11 PM

Document Has Been Signed on 12/30/2021 03:12 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:TUMANYAN FAMILY CHILD CAREFACILITY NUMBER:
197495000
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 0DATE:
12/30/2021
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
12:41 PM
MET WITH:Nina TumanyanTIME COMPLETED:
03:00 PM
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A pre-licensing site visit conducted by Margarit Sislyan, Licensing Program Analysts (LPA) on 12/30/2021. LPA met with applicant, Nina Tumanyan. Applicant was previously licensed and requested change of location.
LPA toured the facility inside and outside.

This is two story single family home with 4 bedrooms and 4 bathrooms. Family members residing at the facility are: 2 adults and no children. Two bedrooms and two bathrooms on the first floor is dedicated for the day activities. Rest of the house is off limit. Children’s access to kitchen, living room and second floor stairs will be restricted via child proof gate.

The home was inspected for safety, comfort, cleanliness, heating and ventilation, inaccessibility to poisons, detergents, cleaning compounds, medicines, and hazardous items that can pose a danger to children.
Per facility sketch there is no pool or other bodies of water on the premises. During the visit LPA did not observe pool or any other bodies of water on the premises. Applicant has provided proof of Preventative Health and Safety. CPR expires on 12/4/2023.
There are age appropriate toys and equipment on the premises.
The required smoke detectors, carbon monoxide detector and fire extinguisher, 2A10BC is in operable condition
Applicant has submitted a disaster plan and demonstrated control of property at the above address by Lease Agreement.
The following discussed: No smoking, no infant walkers, Johnny jumpers, exersaucers or any other that falls into that category.
The LPA also discussed earthquake safety and necessity of drills, required forms for children’s files, facility files and posting requirements. Fingerprint clearance, transfer process and capacity / ratios. Regulation 102416.3 was explained and discussed
with applicant.
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SUPERVISORS NAME: Mary Ruiz
LICENSING EVALUATOR NAME: Margarit Sislyan
LICENSING EVALUATOR SIGNATURE: DATE: 12/30/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/30/2021
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
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: TUMANYAN FAMILY CHILD CARE
FACILITY NUMBER: 197495000
VISIT DATE: 12/30/2021
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Novel Corona virus (COVID-19) Los Angeles County Department of Public Health Guidance for Early Childhood Education Providers was discussed.
Additional information available at: www.publichealth.lacounty.gov

Applicant was informed that it is required by law to post the following in the facility:
● Emergency Disaster Plan (LIC 610A) - This must be posted in your home next to the telephone and
The Earthquake Preparedness Checklist (LIC 9148), must be attached to the LIC610A and available
to the public.
● Notification of Parents' Rights Poster (PUB 394) - This poster must be placed in an area of the home
where all parents can see it
● Facility License, (LIC 203)-Your Family Child Care Home License must be posted in an area of the
home where it can be easily seen.
● Notice of Site Visit (LIC 9213) must remain posted for 30 days (during the hours that children are in care) after each site visit by a licensing representative.● Any licensing report documenting a type “A” citation must be posted for 30 days during the hours that children are in care.

● Any licensing report or other document verifying compliance or non-compliance with the Department’s order to correct a Type “A” deficiency must be posted for 30 days during the hours that children are in care. Employee records must be maintained by the applicant and shall contain the following: LIC9052/Employee Rights, LIC 9108 Mandated Reporter Form, an employment contract or application containing the following information: Employees Full Name, Date of Birth, Driver's License Number, Date of Employment, Documentation of Health and Safety Training, Duties of the employee. Licensee is reminded that records for employees as well as children must be maintained for 3 years after separation for the FCCH.

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SUPERVISORS NAME: Mary Ruiz
LICENSING EVALUATOR NAME: Margarit Sislyan
LICENSING EVALUATOR SIGNATURE:

DATE: 12/30/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/30/2021
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
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: TUMANYAN FAMILY CHILD CARE
FACILITY NUMBER: 197495000
VISIT DATE: 12/30/2021
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LPA discussed the safe sleep for baby pamphlet. Each infant shall be constantly supervised
and under direct visual observation by an adult person at all times. Under no circumstances shall any infant be left unattended. In order to visually observed and supervise sleeping infants there should be no obstruction to the view of the infants, which could include transparency walls and/or half walls. LPA recommend that infants sleep safest in crib with no bumpers, pillows, blankets, or toys, and on their backs, and every sleep time counts to reduce the risk of SIDS and other sleep related causes of infant death

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation provided, an updated Plan of Operation that includes IMS must be submitted to the Department. The following Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is 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.

The following items are needed prior to licensure:
· Fireplaces in the living room shall be screened to prevent access by children.
· Child proof gated shall be installed to prevent children’s access to the restricted areas.


Exit interview

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SUPERVISORS NAME: Mary Ruiz
LICENSING EVALUATOR NAME: Margarit Sislyan
LICENSING EVALUATOR SIGNATURE:

DATE: 12/30/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/30/2021
LIC809 (FAS) - (06/04)
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