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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197700561
Report Date: 03/10/2022
Date Signed: 03/10/2022 03:28:57 PM

Document Has Been Signed on 03/10/2022 03:28 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:BOYAJYAN FAMILY CHILD CAREFACILITY NUMBER:
197700561
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 0DATE:
03/10/2022
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
01:15 PM
MET WITH:Mariam BoyajyanTIME COMPLETED:
03:53 PM
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LPA Liana Stepanyan conducted an announced comprehensive pre-licensing site visit due to a change of location. This visit is to ensure the home meets the health and safety standards as required by regulations governing family childcare homes. LPA met with applicant, also present was applicant’s adult son. Applicant stated her 2 minor children also live in the house. LPA confirmed with applicant that all adults residing in the home have criminal record/TB clearances. Applicant provided evidence of completing Preventative Health Training and has a Pediatric First Aid/CPR which is valid thru March 2022. Applicant will renew her First Aid/CPR this month.

This is a 1-story home, 3-bed, 2-bath house was toured; the following areas are used for daycare: living/dining/family room, hallway bathroom, bedroom #2 and bedroom #3 and backyard for outdoor play. Off limit areas include: kitchen/laundry room, master bedroom/bathroom, and garage. Drawers and lower cabinets in kitchen/bathroom are either latched or do not contain any hazardous items. There is an operational smoke alarm and fire extinguisher maintained in the home. There are adequate age appropriate toys, books, games, and cots for napping. There are no firearms present on the premises as stated by applicant. Furthermore, there are no bodies of water. The outdoor play area is a fenced backyard and has sufficient toys. Per applicant, operating hours are less than 24 hours Monday thru Sunday.
SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Liana Stepanyan
LICENSING EVALUATOR SIGNATURE: DATE: 03/10/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/10/2022
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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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: BOYAJYAN FAMILY CHILD CARE
FACILITY NUMBER: 197700561
VISIT DATE: 03/10/2022
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LPA explained pre-licensing materials including: required posting/recording children/facility documents, regulation highlights, and community resource listing. In addition, LPA reviewed the following with licensee: capacity limitations, supervision, clearances, emergency drills, unusual incidents, mandated reporting, SIDS, and Shaken Baby Syndrome. Applicant is reminded that corporal punishment, smoking, walkers, exersaucers, jumpers and bouncy seats shall never be permitted during daycare operation.

During this inspection facility was observed to be not in compliance with Title 22. Before licensure applicant needs to do the following.

Applicant will make all electrical outlets inaccessible.

Applicant will make exercising equipment inaccessible to children.

All hazardous items such as tools, electrical wires, broom, buckets, and gardening tools will be made inaccessible.

Applicant will have first aid kit with all required items.

Applicant will make steps in the backyard safe for children. Applicant will purchase cushions to place on the concrete floor and have cushions covering the edge of the steps.

Applicant will cover AC unit with a net to make it save for the children.

Exit interview conducted copy of this report was reviewed with applicant.

SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Liana Stepanyan
LICENSING EVALUATOR SIGNATURE:

DATE: 03/10/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/10/2022
LIC809 (FAS) - (06/04)
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