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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197700382
Report Date: 02/21/2023
Date Signed: 02/21/2023 03:23:18 PM

Document Has Been Signed on 02/21/2023 03:23 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, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME:MKRTCHYAN FAMILY CHILD CAREFACILITY NUMBER:
197700382
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 2DATE:
02/21/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:29 PM
MET WITH:Knarik MkrtchyanTIME COMPLETED:
03:45 PM
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On 02/21/2023, Licensing Program Analyst (LPA) Carol Heath and Kristina Diaz conducted an unannounced Required 1-Year inspection at the Mktchyan Family Child Care. Upon arrival, the LPA met with the licensee, Knarik Mktchyan, who guided the LPAs on a tour of the facility. Family members residing in the home include 2 adults (licensee and licensee’s daughter) and grand daughter (10 years old). Per LIS, annual facility fees are current. All adults living in the home have been background cleared. Per the licensee, the hours of operation are Monday through Friday, 4:00 p.m. to 9:00 p.m. There were 2 daycare children (3 months and 2 years old) present during this inspection. Incidental Medical Services (IMS) were discussed. Per the licensee, she does not have children who need IMS at this time.
The home is set up as follows:
This is a two-story house with 5 bedrooms, 3 bathrooms (2 bedrooms downstairs and 3 bedrooms upstairs), and 3 bathrooms (2 upstairs and 1 downstairs). The home with kitchen, Family room, loft, laundry room, living/dining room, backyard, and garage. The garage is used for storage only and no childcare activities are conducted there. There is no pool, spa, or other bodies of water on the premises.
Main Area: Main care is provided in the playroom ( formal dining), and living rooms. Children use the bathroom in the hallway on the left from the main entrance. Children have access to the kitchen and backyard. There are games and books on the premises of this facility. The home was inspected for safety, comfort, cleanliness, telephone service, central air, and heat and ventilation. The home has central heating and air conditioning. All windows have screens and are free of cracks, bugs, and debris.
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Carol Heath
LICENSING EVALUATOR SIGNATURE: DATE: 02/21/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/21/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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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, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: MKRTCHYAN FAMILY CHILD CARE
FACILITY NUMBER: 197700382
VISIT DATE: 02/21/2023
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Ø Main Area: Main care is provided in the Playroom, Dining room, downstairs bedroom#1 (infant room), bathroom #1 , and backyard.
Playroom (Formal Dining Room): In the areas, LPA observed a fireplace that was properly screened via a mirror glass barrier which made it inaccessible to children. LPA observed age-appropriate toys and furniture for the children. LPA observed: A small table was observed with children-size chairs. Several plastic storage bins were observed in which games and toys are stored for the children. A small play kitchen was located by the door with which children could play. There are games and books on the premises of this facility. The mats were observed to be in good condition.

Children’s Bathroom (#1): Children use the bathroom next to the dining room. The Bathroom was toured, and the inspected sink/toilet is operable. The toilet and are clean, safe, and operable. All poison and medications are made inaccessible to children with child safety latches on the sink cabinet and drawers. The bathroom was observed to be free and clear of hazardous items. The bathroom was clean, sanitized, and in good repair.


Kitchen/Dining Room: The kitchen was inspected to ensure hazardous and dangerous items were inaccessible to children (Safety latches). In the kitchen, all sharp utensils, poisons, and medications are made inaccessible to children with child safety latches on sink cabinets and drawers. Sharp knives are kept in a butcher block in the gated kitchen.
Backyard: The backyard was inspected; The backyard is gated all around. The outdoor play area is clean and free from all debris and/or dangerous conditions. The backyard is completely fenced. LPA observed 2 exercise equipments, gardening tools, BBQ grill and other materials.
Off-limit: Off-limit areas include downstairs bedroom #2 (keylock), upstairs: LPA does not observed a safety gate, and the Garage/Laundry area (Safety door knobs)
Ø Others:
· AC/Heating Unit was observed. AC/Heating Unit is located on the right side of the home is inaccessible to children via barrels blocking access to the unit.
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Carol Heath
LICENSING EVALUATOR SIGNATURE:

DATE: 02/21/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/21/2023
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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, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: MKRTCHYAN FAMILY CHILD CARE
FACILITY NUMBER: 197700382
VISIT DATE: 02/21/2023
NARRATIVE
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· Bodies of water: Pre the licensee, there were no bodies of water in the home. There is a decorative water fountain that has no water.
· Electrical outlets: All unused electrical outlets are plugged in and made inaccessible to children.
· Food: The licensee is enrolled in Food program. The licensee will provide Breakfast, lunch, and snacks.
· Fire extinguisher (2A10BC): LPA observed a required fire extinguisher (1A10BC) reading in Green and located near Bathroom #1, inaccessible to children.
· Fireplace: The fireplace was observed in the Family room and is screened to make it inaccessible to the children.
· Hanging window blind cords: The cords are accessible to children.
· Incidental Medical Services (IMS): 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 the publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm. The licensee will not be providing IMS to the children at this time.
· Isolation area (Illness): Per the licensee, if the child shows signs of illness, they will be separated from other children and stay in the Living room
· Medications and cleaning solutions: All poison and medications are made inaccessible to children in the garage.
· Napping: Children will nap in designated areas with adult supervision. LPA observed 5 mats, 1 crib and 1 playpen
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Carol Heath
LICENSING EVALUATOR SIGNATURE:

DATE: 02/21/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/21/2023
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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, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: MKRTCHYAN FAMILY CHILD CARE
FACILITY NUMBER: 197700382
VISIT DATE: 02/21/2023
NARRATIVE
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· Phone service: There is a working landline or cell phone
· Smoke Detectors and Carbon Monoxide: The smoke detectors and carbon monoxide devices tested operable.
· The First Aid kit is located in the key-locked closet, inaccessible to children. The First Aid Kit was observed to be complete with supplies. LPA did not observe a first aid manual.
· Transportation: The licensee does not provide transportation for children.
· Weapons or Firearms: Per the licensee, there are No firearms at the facility.
Ø Documentation:
Child files: LPA observed 4 children's files. 2 children do not have required licensing documents.
CPR/First Aid: LPA observed licensee has current Pediatric CPR and First Aid Training with an expiration date (03/17/24) 1 hour of nutrition training, (8) hours of Preventive Health and Safety Training.
Facility Roster: LPA observed Child Care, Facility Roster. Per Licensing Information System, annual facility fees were current.

Fire Drill and Disaster Drill: Per the licensee, fire, and disaster drills are conducted every 6 months; the last drill was documented and conducted on 01/16/2023.

Immunization: The licensee has the required immunizations. The licensee provided a written statement declining the influenza vaccination.


Infant Sleeping Plan (LIC 9227): LPA shared the information with the licensee. Per Licensee, there is 1 infant (3 months) enrolled in the facility.
Licensee has posted, as required the Facility License, Emergency Disaster plan, and Parents Rights Poster.
Mandated Reporter Training: The licensee has completed the online mandated reporter training at www.mandatedreporterca.com, and will renew 3/16/2024
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Carol Heath
LICENSING EVALUATOR SIGNATURE:

DATE: 02/21/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/21/2023
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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, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: MKRTCHYAN FAMILY CHILD CARE
FACILITY NUMBER: 197700382
VISIT DATE: 02/21/2023
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Staff Personnel File: There is no assistant working in this facility.
The following information was discussed with the licensee:
ü Mandatory Forms for the children's files and provider's files.
ü Requirements for fire drills, earthquake drills, and documentation for both.
ü The licensee is reminded that 100% supervision is required for children at all times.
ü Capacity requirements, Roster requirements, Posting requirements, and Documentation requirements for disaster drills (fire and earthquake). Mandatory Forms for the children's and provider's files and Safe Sleep Awareness. The role and responsibilities of being a mandated reporter were reviewed. The licensee was reminded that supervision is always required for children in care.
ü Licensee was made aware that it is their responsibility to know the regulations and anyone who assists in providing care. Licensee was advised that the inaccessibility of hazards must be constantly reassessed depending on the children in care. Licensing must always have the facility's phone number; if the phone number is changed, licensing must be notified.
ü Licensee was advised of the requirement to report unusual incidents and injuries to the parent/guardian and Licensing within the time frame specified by the regulation and on the form LIC624B
ü The licensee was informed of the responsibility to report suspected Child Abuse by calling the Child Abuse Hotline at 1-800-540-4000. Also, call the CCL office and follow up with a written Unusual Incident/Injury Report (LIC 624B).
ü Criminal Record Statement: Licensee [or facility representative] 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 support or exemption prior to the 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.
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Carol Heath
LICENSING EVALUATOR SIGNATURE:

DATE: 02/21/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/21/2023
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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, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: MKRTCHYAN FAMILY CHILD CARE
FACILITY NUMBER: 197700382
VISIT DATE: 02/21/2023
NARRATIVE
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ü Safe Sleep: LPA discussed the safe sleep regulations with the 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 the 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.
ü A baby walker shall not be allowed on the premises of a family child care home in accordance with Health and Safety code sections 1596.848(b) and (c).
ü Notice of Site Visit: A notice of site visit was given and must remain posted for 30 days.
ü Posting Requirements: Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
ü The regulation prohibits the smoking of tobacco in a private residence that is licensed as a family childcare home and in those areas of the family day care home where children are present (24/7 ban).
ü State law prohibits baby walkers, bouncy seats, exersaucer, and other items that fall into that category.
ü Licensee was advised to visit the CCL website (www.ccld.ca.gov) to obtain updates on courses and updates/changes to the regulations.
n Our Quarterly updates come out every 3 months. They are also now in Spanish. Please log in to the CCLD website, or you can email our advocates to have the quarterly updates sent directly to your email. Child Care Advocates information: www.childcareadvocatesprogram@cdss.ca.gov
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Carol Heath
LICENSING EVALUATOR SIGNATURE:

DATE: 02/21/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/21/2023
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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, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: MKRTCHYAN FAMILY CHILD CARE
FACILITY NUMBER: 197700382
VISIT DATE: 02/21/2023
NARRATIVE
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ü The Duty Worker is available for questions Monday through Friday at (661) 202-3318 from 8:00 a.m. - 5:00 p.m.

ü A copy of the Safe Sleep Proposed Regulations was provided to the licensee.

Deficiencies cited: (See LIC 809D). The following Type B deficiencies are being cited in accordance with Title 22 of the California Code of Regulations and Health & Safety codes.



Exit interview conducted and the report was reviewed with the licensee Knarik Mkrtchyan.
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Carol Heath
LICENSING EVALUATOR SIGNATURE:

DATE: 02/21/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/21/2023
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Document Has Been Signed on 02/21/2023 03:23 PM - It Cannot Be Edited


Created By: Carol Heath On 02/21/2023 at 02:49 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: MKRTCHYAN FAMILY CHILD CARE
FACILITY NUMBER: 197700382

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/21/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102417(g)(3)
Operation of A Family Child Care Home
(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (3) Where children are less than five years old are in care, stairs shall be fenced or barricaded.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above. LPA did not observe a safety gate for the stairs, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 02/23/2023
Plan of Correction
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The licensee will put a safety gate on the stairways
Type B
Section Cited
CCR
102421(a)
Child's Records
(a) The licensee shall maintain, in each child's record, the signed and dated notice form required in Section 102419(d).

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above. LPA observed 4 children files. 2 children do not have require documentation, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 02/24/2023
Plan of Correction
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The licensee will ask parent to fill out the paperwork.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Claretta Yates
LICENSING EVALUATOR NAME:Carol Heath
LICENSING EVALUATOR SIGNATURE:
DATE: 02/21/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/21/2023


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Document Has Been Signed on 02/21/2023 03:23 PM - It Cannot Be Edited


Created By: Carol Heath On 02/21/2023 at 02:49 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: MKRTCHYAN FAMILY CHILD CARE
FACILITY NUMBER: 197700382

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/21/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102425(c)
Infant Safe Sleep
An Individual Infant Sleeping Plan [LIC 9227 (3/20)] shall be completed for each infant up to 12 months of age the provider has in care and included in the infant's file at the facility.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above. LPA observed a 3 month old infant and does not have LIC 9227,which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 02/22/2023
Plan of Correction
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The licensee will have parent fill out the LIC 9227 and email to LPA
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Claretta Yates
LICENSING EVALUATOR NAME:Carol Heath
LICENSING EVALUATOR SIGNATURE:
DATE: 02/21/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/21/2023


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