197700382-2-11-2025-12-CC-JTAO-DDSTT7-20250211140017

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197700382
Report Date: 02/11/2025
Date Signed: 02/11/2025 02:00:33 PM

Document Has Been Signed on 02/11/2025 02:00 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 CARE		FACILITY NUMBER:	197700382
ADMINISTRATOR/ DIRECTOR:	MKRTCHYAN, KNARIK		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(323) 304-5810
CITY:	PALMDALE	STATE: CA	ZIP CODE:	93550
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS: 4	DATE:	02/11/2025
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	12:41 PM
MET WITH:	Knarik Mkrtchyan, Licensee		TIME VISIT/ INSPECTION COMPLETED:	02:33 PM

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On 02/11/2025 Licensing Program Analysts (LPAs) Justeene Tamayo and Hanna Cha met with Licensee Knarik Mkrtchyan who guided analyst on a tour of the facility for the Three Year Required inspection. Upon arrival, LPAs observed 3 preschool age children and 1 infant at the daycare with Licensee caring for them. Family members living in the home are Licensee and Licensee’s husband and no minor children. Hours of operation are 24 hours a day as needed, Monday through Sunday. Incidental Medical Services (IMS) policy was discussed. No children in the daycare with IMS.

Physical Plant: This is a two-story 5 bedroom, 3 bathroom home with kitchen, living room, family room, dining room area, loft, laundry room, and garage. The attached garage was observed to be locked during the time of this inspection. The garage is used for storage only and is garage is off limits to children. Main care is provided in the family room(play room). The main care area is barricaded by two safety gates, one near the front entrance leading to the main care area, as well as another safety gate leading towards the kitchen area. Accessible areas to children are the family room, bedroom #1, bathroom #1, and backyard. The off-limits include all upstairs areas including bedrooms #2-4(barricaded by safety gate), bathroom #2-3(upstairs with safety gate), garage(safety door knob) living room, loft, laundry room, and front yard. The home was inspected inside and out for safety, clean and orderly, comfort, cleanliness, telephone service, heating and ventilation, inaccessibility to poisons, detergents/cleaning compounds(under kitchen sink with safety latch), and medicines(refrigerator with safety latch). Hazardous items (sharp knives are located in an upper kitchen cabinet with operable safety latches).

Safe and age-appropriate toys, play equipment and materials were observed. LPA tested the smoke detector and carbon monoxide detector and observed both to be in operable condition. Fire extinguisher (2A10BC) was found to be in operable condition (in the green) located in the hallway. Electrical outlets were inaccessible. No recalled and or prohibited toys or play equipment were observed on the premises. There is a designated area for ill children as necessary.

Continued on LIC 809-C

SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Justeene Tamayo
LICENSING EVALUATOR SIGNATURE:	DATE: 02/11/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/11/2025

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, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: MKRTCHYAN FAMILY CHILD CARE	FACILITY NUMBER: 197700382
	VISIT DATE: 02/11/2025

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Bathroom: Children use the bathroom located on the right side of the hallway. LPA observed toilet and faucet to be clean and operable. LPA did not observe any hazardous materials in Bathroom #1. LPA reminded applicant the children's bathroom must be free of accessible shampoos, mouthwash, medication, perfumes, razor, air freshener, nail polish and polish remover. LPAs observed no hazardous items underneath the bathroom sink.

Kitchen: The kitchen is off limits to children in care and barricaded with a safety gate. The kitchen was observed to be clean and orderly. Sharp utensils are stored in a kitchen cabinet with an operable safety latch and inaccessible to children in care. The home has a clean and fully stocked refrigerator/freezer. Breakfast, lunch, dinner, and snacks are provided. Licensee stated she is a participant in a food program.

Outdoor: Children play in the back yard. The outdoor play area was observed free of hazards and loose and sharp parts. Safe and age-appropriate toys and materials were observed. There are grass and concrete areas for active play. The front yard is off limits to children. LPAs observed the outdoor air conditioner to be barricaded by a safety gate. The right side of the home has a gate, while the left side of the home is barricaded by cement wall. LPA observed a swing set, and outdoor play equipment. There is cement and turf for active play.

Pools/Spas/Bodies of Water: There are no pools, spas, or bodies of water on the premises.

Advisory/Other: First Aid kit was observed in the hallway with supplies readily available. Licensee’s First Aid/CPR is valid and expires on 02/27/2026. Licensee’s Mandated Reporter training has expired on 03/16/24. Licensee will retake her mandated reporter training, and send proof of completion to LPA Tamayo no later than 02/18/25. LPAs reminded licensee mandated reporter training and CPR must be completed every 2 years. Per Licensee, there is no smoking in the home. Per Licensee there are no pets on the premises. Last fire/disaster drill was completed on 02/06/2025.

Licensee’s annual fees are current. LPA observed all required facility postings on premises. Licensee had the following required posted documents: Notice of Parent's Rights Poster (PUB 394), Facility License (LIC 203) and Emergency Disaster Plan (LIC 610A), and Fire/Disaster Log.

Documents Provided and or Discussed: Earthquake Preparedness Checklist (LIC 9148), Safe Sleep PIN 20-24-CCP and Individual Sleeping Plan (LIC9227). Entrance Checklist - Homes (LIC 126)

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.

Continued on LIC 809-C

SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Justeene Tamayo
LICENSING EVALUATOR SIGNATURE:	DATE: 02/11/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/11/2025

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, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: MKRTCHYAN FAMILY CHILD CARE	FACILITY NUMBER: 197700382
	VISIT DATE: 02/11/2025

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Any duly authorized officer, employee, or agent of the Department shall, upon presentation of proper identification, shall inspect the facility. The Licensee shall permit the Department to inspect the family childcare home, and to privately interview children or staff, to determine compliance with or to prevent violations of family child care laws or regulations, also enter and inspect any place providing personal care, supervision and services at any time, with or without advance notice, to secure compliance with, or to prevent a violation.

Licensee advised of the requirement to report Unusual Incidents. Licensee informed to utilize the Unusual Incident Report/Injury Report LIC624B when submitting the report to the department (email address on the website: www.unusualincidentreport@dss.ca.gov. A report shall be made to the department by telephone or fax during the department's normal business hours before the close of the next working day following the occurrence during the operation of family day care home. In addition, a written report shall be submitted to the department within seven days following the occurrence of any events specified above.

LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep. More information on Infant Safe Sleep procedures can be found online on the CDSS web page at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed licensee 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.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02CCP. 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: https://www.ada.gov/resources/child-care-centers/.

Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

Continued on LIC 809-C

SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Justeene Tamayo
LICENSING EVALUATOR SIGNATURE:	DATE: 02/11/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/11/2025

LIC809 (FAS) - (06/04)

Page: 3 of 5

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: 02/11/2025

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During the exit interview, Licensee, confirmed that there are no Registered Sex Offenders living in the facility and LPAs completed the RSO profile in FAS.

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process

No deficiencies have been cited at this time.

Exit interview conducted, and report was reviewed with the licensee. A notice of site visit was given and must remain posted for 30 days. No citation was given today as a result of this inspection.

SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Justeene Tamayo
LICENSING EVALUATOR SIGNATURE:	DATE: 02/11/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/11/2025

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 02/11/2025 02:00 PM - It Cannot Be Edited

Created By: Justeene Tamayo On 02/11/2025 at 01:47 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: 02/11/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

102419(d)(1)

Admission Procedures and Authorized Representatives Rights

(d) At the time of acceptance of each child into care, the licensee shall provide the child's parent or authorized representative with a copy of the notice Family Child Care Home Notification of Parent's Rights, LIC 995A (8/06), the Caregiver Background Check Process, LIC 995E (6/05), and the Family child Care Consumer Awareness Information, LIC 9212 (10/05). (1) The licensee shall request the child's parent or authorized representative to sign and date the bottom portion of the notice form LIC 995A (8/06), which acknowledges that the parent or authorized representative has received and read the LIC 995A. The bottom portion of this form must be kept in the child’s file as proof that the parent or authorized representative has been notified of his or her rights and received a copy of the Caregiver background Check Process, LIC 995E (6/05), and the Family Child Care Consumer Awareness Information, LIC 9212 (10/05). This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review], the licensee did not comply with the section cited above. LPAs observed children's files to have incomplete LIC995, which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 02/18/2025
	Plan of Correction
1 2 3 4	Licensee will send proof of LIC995 in children's files no later than 02/18/2025.

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:

Mariela Ramon

LICENSING EVALUATOR NAME:

Justeene Tamayo

LICENSING EVALUATOR SIGNATURE:

DATE: 02/11/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/11/2025

LIC809 (FAS) - (06/04)

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