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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197700701
Report Date: 06/20/2024
Date Signed: 06/20/2024 05:48:40 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
This is an official report of an unannounced visit/investigation of a complaint received in our office on
04/05/2024 and conducted by Evaluator Evelyn Garcia
PUBLIC
COMPLAINT CONTROL NUMBER: 12-CC-20240405100739
FACILITY NAME:AZIZYAN FAMILY CHILD CAREFACILITY NUMBER:
197700701
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 8DATE:
06/20/2024
UNANNOUNCEDTIME BEGAN:
12:45 PM
MET WITH:Nelly Azizyan, LicenseeTIME COMPLETED:
06:00 PM
ALLEGATION(S):
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Provider allowed uncleared adult to provide care and supervision to daycare children
INVESTIGATION FINDINGS:
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On 6/20/2024, Licensing Program Analyst (LPA) Evelyn Garcia conducted an unannounced inspection to Azizyan Family Child Care for the purpose of delivering findings and conduct follow up interviews for the above complaint allegation. Upon arrival to the facility, LPA discussed the nature of the visit and were granted entry by licensee. During inspection LPA observed 8 children present and 2 staff providing care and supervision.

The investigation consisted of interviews conducted with children, staff and other relevant parties. The interviews or visits did not disclose any adults who were present in the daycare who were uncleared. Although interviews disclosed that there were other adults who visited the facility, they were fingerprinted and cleared.

See LIC 9099-C for report continuation.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Evelyn Garcia
LICENSING EVALUATOR SIGNATURE:

DATE: 06/20/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/20/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
This is an official report of an unannounced visit/investigation of a complaint received in our office on
04/05/2024 and conducted by Evaluator Evelyn Garcia
PUBLIC
COMPLAINT CONTROL NUMBER: 12-CC-20240405100739

FACILITY NAME:AZIZYAN FAMILY CHILD CAREFACILITY NUMBER:
197700701
ADMINISTRATOR:NELLY AZIZYANFACILITY TYPE:
810
ADDRESS:8659 REMICK AVETELEPHONE:
(818) 301-9411
CITY:SUN VALLEYSTATE: CAZIP CODE:
91352
CAPACITY:8CENSUS: 8DATE:
06/20/2024
UNANNOUNCEDTIME BEGAN:
12:45 PM
MET WITH:Nelly Azizyan, LicenseeTIME COMPLETED:
06:00 PM
ALLEGATION(S):
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Provider is operating over capacity
INVESTIGATION FINDINGS:
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On 6/20/2024, Licensing Program Analyst (LPA) Evelyn Garcia conducted an unannounced inspection to Azizyan Family Child Care for the purpose of delivering findings and conduct follow up interviews for the above complaint allegation. Upon arrival to the facility, LPA discussed the nature of the visit and were granted entry by licensee. During inspection LPA observed 8 children present and 2 staff providing care and supervision.

The investigation consisted of interviews conducted with children, staff and other relevant parties. During the interviews conducted, it was disclosed that there were 11 children at one time.The license capacity only allows for 8 children. The licensee stated, that the over capacity occured during a holiday celebration that placed the facility over capacity. Licensee further stated that the children's parents were not present.

See LIC 9099-C for report continuation and LIC 9099-D for dificiency cited.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Evelyn Garcia
LICENSING EVALUATOR SIGNATURE:

DATE: 06/20/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/20/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 2 of 5
Control Number 12-CC-20240405100739
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION 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: AZIZYAN FAMILY CHILD CARE
FACILITY NUMBER: 197700701
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/20/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
06/20/2024
Section Cited
CCR
102416.5(a)
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STAFFING RATIO & CAPACITY
The capacity specified on the license shall be the maximum number of children for whom care may be provided at any one time. Based on interviews conducted, licensee allowed siblings of daycare children to participate in special
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Licensee wil submit a written statement to the department no later than 6/21/24 with a plan of correction of how she will ensure that at no given time there will be more than 8 children under her care.
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events, bringing the number of children present, over the capacity. This is a type A violation that poses an immediate risk to the health and safety of the children in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Evelyn Garcia
LICENSING EVALUATOR SIGNATURE:

DATE: 06/20/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/20/2024
LIC9099 (FAS) - (06/04)
Page: 3 of 5
Control Number 12-CC-20240405100739
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION 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: AZIZYAN FAMILY CHILD CARE
FACILITY NUMBER: 197700701
VISIT DATE: 06/20/2024
NARRATIVE
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On June 27, 2024, this complaint investigation report LIC 9099C is amended to remove information added in error.

Based on statements during interviews conducted with children, licensee, staff and other relevant complaint parties and other documentation obtained during inspection, the allegation- Provider is operating over capacity is deemed SUBSTANTIATED and a citation will be issued (See LIC 9099-D for cited deficiency).

The facility was cited a Type A violation.

An exit interview was conducted, and a copy of this report was provided along with the appeal rights.
SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Evelyn Garcia
LICENSING EVALUATOR SIGNATURE:

DATE: 06/20/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/20/2024
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 12-CC-20240405100739
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION 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: AZIZYAN FAMILY CHILD CARE
FACILITY NUMBER: 197700701
VISIT DATE: 06/20/2024
NARRATIVE
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Based on statements during interviews conducted with children, staff and other relevant complaint parties and other documentation obtained during inspection, the allegation- provider allowed uncleared adult to provide care and supervision to daycare children is deemed Unsubstantiated. A finding that the complaint is unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged allegation did or did not occurr.

An exit interview was conducted, a signed copy of this report was provided to licensee, as well as her appeal rights. A Notice of Site Visit was left at the facility to be posted for 30 calendar days.
SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Evelyn Garcia
LICENSING EVALUATOR SIGNATURE:

DATE: 06/20/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/20/2024
LIC9099 (FAS) - (06/04)
Page: 5 of 5