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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197700675
Report Date: 04/20/2023
Date Signed: 04/20/2023 03:13:53 PM

Document Has Been Signed on 04/20/2023 03:13 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:SARGSYAN FAMILY CHILD CAREFACILITY NUMBER:
197700675
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 0DATE:
04/20/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
02:50 PM
MET WITH:TIME COMPLETED:
03:30 PM
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On 04/20/2023 Licensing Program Analyst (LPA) Andrew Alemoh met with Applicant Oksanna Sargsyan to conduct an unannounced case management pre-licensing inspection. The purpose of the case management inspection was to inspect the pool gate. Upon arrival, LPA observed 0 children in care.

On 03/09/2023 LPA conducted a pre-licensing inspection at the above facility and found the pool gate to be not in compliance with title 22 regulations

During today's visit LPA Andrew toured the home and assessed the pool gate to be in compliance with Title 22 Regulations.

There is a swimming pool in the backyard. The bodies of water are completely enclosed by a 6 ft mesh fence. The fence runs all the way down to the concrete on which it sits, leaving no room between the bottom of the fence and the concrete. The pool gate was tested and observed to have a locking mechanis . The gate has an perma-lock mechanism and it is located within 6 inches from the top of the gate. The lever to open the gate is located at the top of the gate. The pool gate opens away from the body of water. All items rendering the fence climbable are moved away from the fence. The mesh fencing is sturdy and capable of withstanding the impact of children's toys including bicycles. LPA took photos, as well as applicant provided photo copies of the pool. LPA will file away photos of the pool in the facility file.

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

An exit interview was conducted, a copy of this report was reviewed along with appeal rights were provided to applicant Oksanna Sargysyan



SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Andrew Alemoh
LICENSING EVALUATOR SIGNATURE: DATE: 04/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/20/2023
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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