197700534-8-10-2023-12-CC-AVIA-CUKT55-20230810142457

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197700534
Report Date: 08/10/2023
Date Signed: 08/10/2023 02:25:44 PM

Document Has Been Signed on 08/10/2023 02:25 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
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME:	PIRIJANYAN FAMILY CHILD CARE		FACILITY NUMBER:	197700534
ADMINISTRATOR:	ARMAN PIRIJANYAN		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(818) 314-7802
CITY:	SUNLAND	STATE: CA	ZIP CODE:	91040
CAPACITY:	14	CENSUS: 8	DATE:	08/10/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	01:00 PM
MET WITH:	Arman Pirijanyan, Licensee		TIME COMPLETED:	03:30 PM

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On August 10, 2023, Licensing Program Analyst (LPA) Annelise Villa met Arman Pirijanyan who guided analyst on a tour of the facility for the One Year Required inspection. Upon arrival, LPA observed 8 preschool age children in care. Family members residing in the home are Licensee. Hours of operation are Monday through Friday, 7:00 am to 6:00 pm. Incidental Medical Services (IMS) policy was discussed.

Physical Plant: This is a one story 2-bedroom, 1-bathroom home with kitchen, living room, and family room. Main care is provided in the family room. Children use the bathroom #1 located on the right hand side of the daycare area. Children nap on cots in the main care area. Off limit areas include the kitchen, living room, and bedrooms #2 and #3, and front yard. The home was inspected inside and out for safety, comfort, cleanliness, telephone service, heating and ventilation, inaccessibility to poisons. Cleaning supplies, medications and alcohol were inaccessible to children in care.

Safe and age-appropriate toys, play equipment and materials were observed. The smoke detector, carbon monoxide detector and Fire Extinguisher (2A10BC) are all in operable condition. 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. Per Licensee, there are no weapon/firearms in the home. The facility sketch is complete and current, there is working a telephone.

Bathroom: Children use Bathroom #1 located in the right side of the main care area. LPA observed toilet and faucet are clean and operable. Cleaning supplies were observed to be kept under the sink with a safety latch, making them inaccessible to children in care.

Continued on LIC 809-C

SUPERVISOR'S NAME: Mariela Ramon	TELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Annelise Villa	TELEPHONE: 661-202-3786
LICENSING EVALUATOR SIGNATURE:	DATE: 08/10/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/10/2023

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

FACILITY NAME: PIRIJANYAN FAMILY CHILD CARE	FACILITY NUMBER: 197700534
	VISIT DATE: 08/10/2023

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Kitchen: Sharp utensils, open bottles or alcohol are inaccessible. The home has a clean and fully stocked refrigerator/freezer. Breakfast, lunch, dinner, and snacks are provided. Licensee stated he is a participant in a food program.

Outdoor: Children play in the back yard. LPA toured the back yard and observed it to be free of garden tools, poisonous plants, thorn trees, cactus, or lawn mower inaccessible to children. The play area is clear and clean of debris, play area is fenced and gated all around. LPA observed the back yard to be barricaded by a latched gate. LPAs observed age appropriate play equipment for children.

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

Advisory/Other: First Aid kit was observed in the childcare area with supplies readily available. CPR/First Aid expires on 9/18/2023. Mandated Reporter Training Certificate expires on 9/24/2023. LPA reminded licensee mandated reporter training and CPR must be completed every 2 years.

The facility annual fees are current. Licensee had all the required posted documents: Facility License (LIC 203), Notice of Parent's Rights Poster (PUB 394), Emergency Disaster Plan (LIC 610A), and Earthquake Preparedness Checklist (LIC 9148). Last fire/disaster drill was completed on 8/10/2023.

Documents Provided and or Discussed: Fire Drill Log, Postings, Employee's and Children's records, Safe Sleep PIN 20-24-CCP and Individual Sleeping Plan (LIC9227). Licensee currently does not have childcare insurance.

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

SUPERVISOR'S NAME: Mariela Ramon	TELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Annelise Villa	TELEPHONE: 661-202-3786
LICENSING EVALUATOR SIGNATURE:	DATE: 08/10/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/10/2023

LIC809 (FAS) - (06/04)

Page: 2 of 4

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: PIRIJANYAN FAMILY CHILD CARE	FACILITY NUMBER: 197700534
	VISIT DATE: 08/10/2023

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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 child care 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.

LPAs discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep web page at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPAs 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.

An exit interview was conducted, a copy of this report was reviewed and provided to licensee along with the appeal rights.

SUPERVISOR'S NAME: Mariela Ramon	TELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Annelise Villa	TELEPHONE: 661-202-3786
LICENSING EVALUATOR SIGNATURE:	DATE: 08/10/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/10/2023

LIC809 (FAS) - (06/04)

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