<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197700855
Report Date: 07/29/2024
Date Signed: 07/29/2024 12:09:45 PM

Document Has Been Signed on 07/29/2024 12:09 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:PIRIJANYAN FAMILY CHILD CAREFACILITY NUMBER:
197700855
ADMINISTRATOR/
DIRECTOR:		ARMAN PIRIJANYANFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(818) 314-7802
CITY:SUNLANDSTATE: CAZIP CODE:
91040
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 0DATE:
07/29/2024
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:00 AM
MET WITH:Applicant Arman PirijanyanTIME VISIT/
INSPECTION COMPLETED:
01:00 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 07/29/2024, Licensing Program Analyst (LPA) Andrew Alemoh conducted an announced relocation inspection for the purpose of conducting Family Child Care Home pre-licensing relocation inspection for a Large Family Child Care. LPA was greeted by the applicant who guided the LPA on a tour of the facility.

There are no bodies of water on the premises.

Applicant will operate Monday through Sunday from 8AM - 5:30PM hours depending on family's need. Overnight care will not be provided. The Applicant will provide breakfast, lunch, late lunch and x2 snacks. A Food Nutrition Program from the Ventura Country Daycare Food Program will be initiated into the facility. A learning curriculum will be initiated into the day care home.



This is a one story family home w/ 4 bedrooms and 2 bathrooms. The home consist of a kitchen, living room(play area/classroom), an attached garage(w/ the laundry room located in the garage) and a back yard. The living room area will be the the primary location in which care is provided referred to as the Child Care Play area or the classroom. Children will utilize the restroom located in off-limits bedroom #1. Bedroom #1 will be a pathway to the children's restroom.
SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Andrew Alemoh
LICENSING EVALUATOR SIGNATURE: DATE: 07/29/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/29/2024
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 7
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: PIRIJANYAN FAMILY CHILD CARE
FACILITY NUMBER: 197700855
VISIT DATE: 07/29/2024
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
The home was inspected inside and out for safety, comfort, cleanliness, service, heating and center air ventilation. The home has age appropriate toys, play equipment, tables and chairs and materials. Per applicant he will be adding additional play equipment upon children's request. The sharp knives(at the time of this visit no sharp knives on the premies however at a later date they will be stored in the top kitchen cabinet.) Medication(stored in applicant bedroom) and cleaning supplies(per applicant cleaners come into the facility at the end of the day to clean the facility). Cleaning chemicals(stored in the locked cabinet and are inaccessible to children.) Applicant has a complete First Aid Kit with a thermometer in the play area/classroom area, which is stored inaccessible to children.

The children's bathroom was observed to be locked in the off-limits bedroom #1 area. Per applicant the bedroom will be utilized as a diaper changing station area, and potty training along with access to the children's bathroom. LPA observed the bathroom to be clean and orderly. There is a shower located in the bathroom. Per applicant plans to get a shower curtain and safety gate to block access to the bathroom. There are no prohibited items in the bathroom. Toilet and sink to be clean and in operable condition.



LPA observed a fire extinguisher (3A40BC) that meets the State Fire Marshal standards (reading in green). Applicant tested the smoke detector and carbon monoxide detector to be found to be in operating condition according to the Fire Marshal standards. Per applicant there are no weapons or firearms in the home, nor did LPA observe any weapons or firearms during the inspection. There is no fireplace observed on the premises.
SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Andrew Alemoh
LICENSING EVALUATOR SIGNATURE:

DATE: 07/29/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/29/2024
LIC809 (FAS) - (06/04)
Page: 2 of 7
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: PIRIJANYAN FAMILY CHILD CARE
FACILITY NUMBER: 197700855
VISIT DATE: 07/29/2024
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
Children will be provided with cots/beds as well as cribs for nap time. The off-limit areas are: all bedrooms, applicant office, one restrooms, laundry room(located in the garage) kitchen(all cabinets locked with safety latched) and the attached garage.

The back yard is fenced in all around and enclosed. Turf grass was observed all around the outside area, along with trees for shade and rest. Tables and benches were observed to be age appropriate for children. Per applicant more additional play equipment will be added to the outside play yard area at a later date. Applicant intends to add outside cameras. The right side of the home has a gate that will be utilized as the front entrance to the facility. The front entrance gate has a lock and a ring camera. The left side of the home has a gate that gives access to the front yard. Per applicant the left side gate will be locked at all times. No BBQ grill was observed on the premises. AC unit was observed to be made inaccessible to children. No pets nor animals were observed on the premises.

Playroom area(classroom) was observed to be clean and orderly. Safe and age appropriate toys and play equipment was observed. Play mats observed in the classroom area. More additional toys/play equipment will be added per applicant statements. A plug in piano was observed in the classroom area for children to learn the piano. There are tables and chairs for children to sit, learn and observe. Applicant was reminded about ensuring proper care and visual supervision at all times.

The Applicant Pediatric CPR/First Aid expires on 09/2025. The Applicant had the required immunization against pertussis (Tdap), measles (MMR), and tuberculosis (TB). Family Child Care Orientation was completed 09/23/2021. Preventative Health and Safety training with lead and nutrition component is dated 09/18/2021. Child Care Provider Mandated Reporter training is dated 11/14/2025.

SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Andrew Alemoh
LICENSING EVALUATOR SIGNATURE:

DATE: 07/29/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/29/2024
LIC809 (FAS) - (06/04)
Page: 3 of 7
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: PIRIJANYAN FAMILY CHILD CARE
FACILITY NUMBER: 197700855
VISIT DATE: 07/29/2024
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
Applicant will have the parent board and other Licensing required forms at the entrance of the day care, visible to parents.

The following was discussed with applicants:

Infant safe sleep PIN, Infant Safe Sleep Plan(LIC9227) and safe sleep log were provided.

Mandatory licensing forms for the children’s files, facility forms/records, and information to be posted in the family child care home; Requirements to conduct fire and disaster drills once every six months and record it; Role and responsibilities of being a mandated reporter were reviewed; Applicant was made aware that it is her responsibility to know the regulations as well as anyone who assists in providing care; Licensing must have the facility’s phone number at all times; if the phone number is changed, licensing must be notified; Regulation prohibits the smoking of any kind in the family child care home.

The Applicant was informed that all adults living in or having access to the home, or employees are required to have fingerprint clearances with Department of Justice, FBI and Child Abuse Central Index prior to having contact or working with children.



If the aforementioned is not adhered to, a Civil Penalty of up to $500, per non-cleared adult will be assessed immediately. Please advise your analyst of any person who will be visiting regularly or for longer than one week. The applicant was advised to utilize the Request for Live Scan Service form LIC9163 to have adults fingerprinted and associated to the home.
SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Andrew Alemoh
LICENSING EVALUATOR SIGNATURE:

DATE: 07/29/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/29/2024
LIC809 (FAS) - (06/04)
Page: 4 of 7
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: PIRIJANYAN FAMILY CHILD CARE
FACILITY NUMBER: 197700855
VISIT DATE: 07/29/2024
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
The Applicant was advised of the requirement to report Unusual Incidents. A report shall be made to the department by telephone or fax during the department's normal business hours before the close of the next working day following the occurrence during the operation of family day care home. In addition, a written report shall be submitted to the department within seven days following the occurrence of any events specified above. The applicant was informed to utilize the Unusual Incident Report/Injury Report form LIC624B when submitting the report to the department.

The Applicant was advised that the Notice of Site Visit must be posted at the entrance of the facility for a period of 30 days whenever a licensing inspection is conducted. If a Type A deficiency is cited, a copy of the licensing report must also be posted for 30 days. The same report must be provided to parents/guardians of children newly enrolled at the facility during the next 12 months and applicant must obtain a signed Acknowledgement of Licensing Reports (LIC 9224) from parent/guardian and place it in each child's file. Copies of the reports must be provided to each parent when a Type A violation is cited along with Acknowledgment of Receipt of Licensing Reports (LIC 9224). If these requirements are not met civil penalties per violation will be assessed.



Beginning on January 1, 2018, Assembly Bill 1207 (2015) requires all licensed providers, applicants, directors and employees to complete training as specified on their mandated reporter duties and to renew their training every two years. Applicants must meet requirements as a precondition to licensure. New employees shall have 90 days from date of employment to complete training as required. The training may be conducted at the following website www.mandatedreporterca.com. This certificate is valid for two years.
SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Andrew Alemoh
LICENSING EVALUATOR SIGNATURE:

DATE: 07/29/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/29/2024
LIC809 (FAS) - (06/04)
Page: 5 of 7
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: PIRIJANYAN FAMILY CHILD CARE
FACILITY NUMBER: 197700855
VISIT DATE: 07/29/2024
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



The Applicant was advised it is her responsibility to visit the department's website to access licensing forms, Quarterly Updates and Provider Information Notices (PINs): www.ccld.ca.gov
Child Care Advocates:
To sign up for our Quarterly Updates and Provider Information Notices (PINs), please subscribe online: http://www.cdss.ca.gov/inforesources/Community-Care-Licensing/subscribe


The following was provided to the Applicant: All licensing forms required in children's files; All licensing forms required in the facility; All licensing forms to be posted in the home; Fire and Disaster Drill log; California Car Seat Flyer; Safe Sleep Flyer; Parent Notification Requirements; and Safe Sleep-in Child-Care brochure; and additional resources for the applicant and her Family Child Care Home.
SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Andrew Alemoh
LICENSING EVALUATOR SIGNATURE:

DATE: 07/29/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/29/2024
LIC809 (FAS) - (06/04)
Page: 6 of 7
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: PIRIJANYAN FAMILY CHILD CARE
FACILITY NUMBER: 197700855
VISIT DATE: 07/29/2024
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
The Appliant has met Title 22 regulations a Small Family Child Care Home a relocation License with a child care capacity of 14 children will be granted today 07/29/2024.

An exit interview was conducted, and a copy of this report was provided to applicants. All Licensing reports are recommended to be kept on file for minimum three years.
SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Andrew Alemoh
LICENSING EVALUATOR SIGNATURE:

DATE: 07/29/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/29/2024
LIC809 (FAS) - (06/04)
Page: 7 of 7