197700728-6-10-2024-12-CC-IORA-D64U8A-20240610152111

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197700728
Report Date: 06/04/2024
Date Signed: 06/10/2024 03:21:32 PM

Document Has Been Signed on 06/10/2024 03:21 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:	GRIGORYAN FAMILY CHILD CARE		FACILITY NUMBER:	197700728
ADMINISTRATOR/ DIRECTOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 8	CENSUS: 5	DATE:	06/04/2024
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	03:00 PM
MET WITH:	Narine Grigoryan, Licensee		TIME VISIT/ INSPECTION COMPLETED:	05:18 PM

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25

On 06/04/2024 Licensing Program Analyst(LPA) Isabel Ortega conducted a Case Management inspection as Licensee is requesting to increase capacity from 8 children to 14 children. LPA announced the purpose of the inspection and was granted entry by Licensee. A tour of the facility was completed. Upon arrival LPA did observe five children in care and three staff staff providing care and supervision.

Licensee was initially licensed on 11/13/2023 as a Small Family Child Care Home. The Fire Department has inspected the home and granted a fire clearance for 14 children on 5/01/2024. Family Child Care Home operates Monday through Friday from 6:00 am to 6:00 pm. The facility provides breakfast, morning snack, lunch, dinner and afternoon snack when needed.

This is a single story with three-bedrooms, two restrooms. Bedroom #1 is referred to as the classroom. Bedroom #2 is the Infant classroom. Children utilize the restroom located in bedroom #1(classroom). The off-limit areas include the kitchen(sliding door observed), and bedroom #3(maintained key locked).

The home was inspected inside and out for safety, comfort, cleanliness, telephone service, heating and ventilation, inaccessibility to poisons, detergents, cleaning compounds, medicines, and hazardous items that can pose a danger to children.

SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Isabel Ortega
LICENSING EVALUATOR SIGNATURE:	DATE: 06/04/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/04/2024

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

FACILITY NAME: GRIGORYAN FAMILY CHILD CARE	FACILITY NUMBER: 197700728
	VISIT DATE: 06/04/2024

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

There are age appropriate toys and equipment on the premises. LPA did not observe a fireplace or any bodies of water. Per the licensee there are no weapons or firearms of any kind in the facility, nor did the LPA observe any weapons during inspection. LPA observed cots for napping and playpens for infants.

The backyard is utilized by the children for outside play and is fenced all around. The outdoor play area was inspected and play equipment was observed to be free of hazards, loose and sharp parts. LPA observed age appropriate toys both inside and outside of the home.

The facility’s fire extinguisher (2A10BC) is reading in green and met the State Fire Marshal standards. The fire department tested the smoke and carbon monoxide, LPA observed detectors to be operating. The facility annual fees are current. The parent board was reviewed and had all the required forms posted and accessible to parents.

Licensee provided a current valid Pediatric First aid and CPR certificate dated 1/12/2023 which does not expire until 1/12/2025. The Mandated Reporter Child Care Provider certificate is dated 10/01/2023.

Licensee is reminded with a capacity increase she must have a qualified assistant present whenever she has more than 8 children in care. Licensee was provided with a capacity and ratio handout pertaining to large Family Child Care Homes and the various age groups that can be under care at one given time.

SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Isabel Ortega
LICENSING EVALUATOR SIGNATURE:	DATE: 06/04/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/04/2024

LIC809 (FAS) - (06/04)

Page: 2 of 3

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: GRIGORYAN FAMILY CHILD CARE	FACILITY NUMBER: 197700728
	VISIT DATE: 06/04/2024

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at http://www.ada.gov/childqanda.htm
Licensee was reminded with a capacity increase she must have a qualified assistant present whenever she has more than 8 children in care.

Licensee has met Title 22 regulations; Fire clearance was granted 5/01/2024, therefore, a Large Family Child Care Home License capacity of 14 children has been granted effective 06/04/2024.

An exit interview was conducted, and a copy of this report, appeal and notice of site visit was provided to Licensee on this day. All Licensing reports are recommended to be kept on file for a minimum of three years.

SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Isabel Ortega
LICENSING EVALUATOR SIGNATURE:	DATE: 06/04/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/04/2024

LIC809 (FAS) - (06/04)

Page: 3 of 3