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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197700661
Report Date: 08/09/2024
Date Signed: 08/09/2024 02:19:53 PM

Document Has Been Signed on 08/09/2024 02:19 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:HOVHANNISYAN FAMILY CHILD CAREFACILITY NUMBER:
197700661
ADMINISTRATOR/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 2DATE:
08/09/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:00 PM
MET WITH:Edita Hovhannisyan, Licensee TIME VISIT/
INSPECTION COMPLETED:
03:00 PM
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On 08/09/2024, Licensing Program Analyst (LPA) Justeene Tamayo conducted an annual inspection with licensee Edita Hovhannisyan, who guided LPA on a tour of the facility. This is a one-story house with 3 bedrooms, and 3 bathrooms, living room, dining room, and kitchen. There are no bodies of water on the premises. The adults residing in the home are (licensee and licensee's spouse, and licensee's adult sister) and three minor children. LPA observed 2 preschool children in care, along with licensee and assistant #1.

The facility operates Monday through Friday, from 8AM-5:30 PM. Main care is provided in the living room. Children eat in the main care area. The day care children utilize the bathroom on the right hand side of the hallway and bathroom #3 located near the backyard if needed where the laundry room is located. Children use the back yard for outdoor play. Bedrooms #2 and #3, bathrooms #2, and front yard are off limits to the day care children.

LPA observed day care area to be clean and orderly, central air and heating, age-appropriate toys and play equipment, working smoke and carbon monoxide detectors are in operable condition.

LPA reminded licensee the children's bathroom must be free of shampoos, mouthwash, medication, perfumes, razor, air freshener, nail polish and polish remover. LPA observed a clean, safe and operable toilet and faucet.

LPA observed a fully charge 2A10BC fire extinguisher during the inspection located in the kitchen. First aid kit is located in the kitchen area. Medications are stored in the refrigerator with a safety latch. Cleaning items are inaccessible to children stored underneath the kitchen sink which is off limits and made inaccessible with a safety latch.

Continued on LIC 809-C

SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Justeene Tamayo
LICENSING EVALUATOR SIGNATURE: DATE: 08/09/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/09/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 3
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: HOVHANNISYAN FAMILY CHILD CARE
FACILITY NUMBER: 197700661
VISIT DATE: 08/09/2024
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Fire/Disaster Drill is complete and maintained current. Last Fire/Disaster drill was completed on 04/02/2024. Licensee's CPR/First Aid expires on 03/27/2026. Licensee's mandated reporter training expires on 11/25/2024.

Kitchen: The kitchen was observed to be clean and orderly. The following are inaccessible: Sharp items are stored in a kitchen cabinet, with a safety latch and inaccessible to children in care. LPA observed the refrigerator and freezer to be clean. LPA discuss with licensee food shall be properly stored or refrigerated in container that are labeled with child’s name when supplied by parent. The kitchen will be off limits to children in care. Licensee does not utilize a food program, but cooks for the day care children. Breakfast, lunch, snacks, and dinner are provided.

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. LPA observed the outdoor air conditioning unit and electrical box to be completely blocked off by a gate and secured with a latch. Licensee stated there are no pets on the premises. Per licensee, no firearms are present on the premises. LPA did not observe any prohibited toys or sleep equipment on the premises.

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.

Documents Provided and or Discussed: The following were provided to comply with Title 22 requirements: Fire Drill Log, roster, Safe Sleep PIN 20-24-CCP, Individual Sleeping Plan (LIC 9227), water lead poster, required postings and list of CCLD forms required for child file each child in care (LIC 311D). Licensee stated currently does not have childcare insurance but plans to. Child Care Advocates information: www.childcareadvocatesprogram@cdss.ca.gov

Licensee was advised of the requirement to report unusual incidents and/or injuries to the parent/guardian and Licensing within 24 hours of incident by telephone and in writing within 7 day of incident to the department. Applicant was informed all suspected Child Abuse should be reported to the Child Abuse Hot-line at 1-800-540-4000. The above incident should be reported on the form LIC624B per the regulation. The form should be email to unusualincidentreport@dss.ca.gov

Continued on LIC 809-C

SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Justeene Tamayo
LICENSING EVALUATOR SIGNATURE:

DATE: 08/09/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/09/2024
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: HOVHANNISYAN FAMILY CHILD CARE
FACILITY NUMBER: 197700661
VISIT DATE: 08/09/2024
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LPA discussed the safe sleep regulations with licensee Hovhannisyan 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 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.

No deficiencies have been cited at this time.

A notice of site visit was given to licensee and must remain posted for 30 days.

Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with licensee Edita Hovhannisyan, along with her appeal rights and Notice of Site Visit.

SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Justeene Tamayo
LICENSING EVALUATOR SIGNATURE:

DATE: 08/09/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/09/2024
LIC809 (FAS) - (06/04)
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