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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197495164
Report Date: 11/15/2022
Date Signed: 11/15/2022 09:55:11 AM

Document Has Been Signed on 11/15/2022 09:55 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:MANUKYAN FAMILY CHILD CAREFACILITY NUMBER:
197495164
ADMINISTRATOR:LUSINE MANUKYANFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(818) 392-0730
CITY:LAKE BALBOASTATE: CAZIP CODE:
91406
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: DATE:
11/15/2022
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
09:35 AM
MET WITH:Luisine ManukayanTIME COMPLETED:
09:51 AM
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On November 15, 2022, Licensing Program Analyst (LPA) Doris Whitmore conducted an announced inspection with applicant Luisine Manukayan, for the purpose of observing the corrections from the prior pre-licensing inspection on 10/28/2022.

LPA Whitmore observed the following corrections: Safety locks were added to the middle of the outdoor stove and lower bottom, the latch on the upper part of the gate around the pool now swings away from the pool and self closes and self-latches on its own. The Plastic wrap on the counter has been removed. The outlet next to the refrigerator the green extension cord has been removed completely. The screws that were protruding has been covered. Curtain around the pole has been placed higher. Safety locks were added to the closet doors. A white safety gate was added to prevent access to the side of the house that leads to the kitchen back door.

File will be given for managerial review prior to licensure.

An exit interview was conducted and a copy of report was provided to the applicant.

SUPERVISORS NAME: Karren Starks
LICENSING EVALUATOR NAME: Doris Whitmore
LICENSING EVALUATOR SIGNATURE: DATE: 11/15/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/15/2022
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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