197495122-7-1-2024-58-CC-BCLD-D6RTTP-20240701150105

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197495122
Report Date: 07/01/2024
Date Signed: 07/01/2024 03:01:12 PM

Document Has Been Signed on 07/01/2024 03:01 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:	TADEVOSYAN FAMILY CHILD CARE		FACILITY NUMBER:	197495122
ADMINISTRATOR/ DIRECTOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 8	CENSUS: 8	DATE:	07/01/2024
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	01:30 PM
MET WITH:	Zaruhi Tadevosyan, Licensee		TIME VISIT/ INSPECTION COMPLETED:	03:30 PM

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On July 1, 2024 at 01:30 P.M., Licensing Program Analyst (LPA) Brittanee Cleveland conducted unannounced case management inspection to the above facility. This is a small family childcare home, up to 8 children – ages 0 years of age to 14 years of age. The family childcare home operates Monday through Sunday 05:00 a.m. to 09:00 p.m. LPA met with Licensee, Zaruhi Tadevosyan, who guided LPA on a tour of the inside and outside of the home. Licensee’s assistant was also present in the home during inspection. LPA observed 8 children in care at the time of inspection.

The purpose of this inspection is due to licensee submitted application for a capacity increase. Licensee qualifies for a capacity increase due to being licensed for over a year.

Individuals who reside in the home were noted and discussed. Per Licensee, there is one assistant.

This is a one-story home which consists of 4 bedrooms, 2 bathroom, kitchen, dining room, living room, front yard, and backyard (fenced). Per applicant, areas off limits to children and parents include: 2 bedrooms, the backyard, and living room. All off limit areas are separated by gates to remain inaccessible to children. The licensee provides food for children in care. Sleeping room serves as an isolation area if a child is to be sick while in care.

All areas identified on the Facility Sketch were inspected. The areas accessible to the children to use were inspected for safety, comfort, and cleanliness. There is telephone service via a cellphone that stays in the facility with the licensee. There is ventilation and heating in the home. Safe toys play equipment and materials were observed.

Applicant states that there are no firearms stored in the home.

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SUPERVISORS NAME: Raul Navarro
LICENSING EVALUATOR NAME: Brittanee Cleveland
LICENSING EVALUATOR SIGNATURE:	DATE: 07/01/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/01/2024

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: TADEVOSYAN FAMILY CHILD CARE	FACILITY NUMBER: 197495122
	VISIT DATE: 07/01/2024

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Licensee states that she currently no infants enrolled. The licensee states that they will purchase a crib and changing table for an infant. LPA discussed sleeping and napping arrangements for children in care.

Each child has a name tag on cots and all blankets are washed weekly. New cots have been purchased for the capacity increase. The dining room serves as a playroom and sleeping area for the children. A door separates the play area from the home hallway where the sleeping room and restroom are located. All kitchen areas/food preparation areas and food storage areas are kept clean and are free of any hazards. All electrical outlets are covered. All doorknobs are covered by protectors.

The valve on the required 2A 10BC fire extinguisher indicates fully charged but was purchased in 2022, based on receipt. Smoke and carbon monoxide detectors were tested and are operable. LPA informed licensee to continue to have fire extinguisher serviced yearly or purchase a new one.

The licensee and the assistant have completed the required Health and Safety Training, Nutrition Training and Pediatric First Aid and CPR, and Mandated Reporter Training Certificates of completion were verified to be on file in the facility. There are first aid supplies available and stored in an area inaccessible to children.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department. The following 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

LPA reviewed with applicant the LIC 311D, Forms/Records To Keep In Your Family Child Care Home, children's forms/records, facility forms/records, and information to be posted. LPA advised the applicant on how to access forms, regulations and quarterly updates on the Child Care Licensing website at: www.ccld.ca.gov. LPA provided the following documents about SIDS: A Child Care Provider's Guide to Safe Sleep from the American Academy of Pediatrics, Helping You to Reduce the Risk of SIDS, Never Shake a Baby, and Safe Sleeping practices.

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SUPERVISORS NAME: Raul Navarro
LICENSING EVALUATOR NAME: Brittanee Cleveland
LICENSING EVALUATOR SIGNATURE:	DATE: 07/01/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/01/2024

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: TADEVOSYAN FAMILY CHILD CARE	FACILITY NUMBER: 197495122
	VISIT DATE: 07/01/2024

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Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platform. To receive important licensed related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

Per licensee, there are no dual licenses at this address. Licensee email address was submitted obtained during this inspection. The licensee was advised that email may be public information.

LPA has requested the following corrections for the family childcare home. Licensee must send photo proof of new beds purchased. Licensee must purchase a changing table and crib for when an infant is enrolled. Licensee needs to purchase a new fire extinguisher or have the current fire extinguisher serviced and send proof to LPA.

A large family child care license with a capacity of 14 may be granted upon manager review and approval. Once licensed, the licensee is required to adhere to the terms and limitations stated on the license.

The Notice of Site Visit (LIC 9213) – must remain posted for 30 days during the hours of operation after each site visit by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00.

A copy of the report and appeals rights were provided to the Licensee.

An exit interview was conducted and report was reviewed with Zaruhi Tadevosyan, Licensee.

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SUPERVISORS NAME: Raul Navarro
LICENSING EVALUATOR NAME: Brittanee Cleveland
LICENSING EVALUATOR SIGNATURE:	DATE: 07/01/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/01/2024

LIC809 (FAS) - (06/04)

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