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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197700921
Report Date: 04/01/2025
Date Signed: 04/01/2025 11:54:54 AM

Document Has Been Signed on 04/01/2025 11:54 AM - 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 CC RO, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME:MARDOYAN FAMILY CHILD CAREFACILITY NUMBER:
197700921
ADMINISTRATOR/
DIRECTOR:		TAMARA MARDOYANFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(818) 294-9506
CITY:SUNLANDSTATE: CAZIP CODE:
91040
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 0DATE:
04/01/2025
TYPE OF VISIT:PrelicensingANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:35 AM
MET WITH:Tamara Mardoyan, ApplicantTIME VISIT/
INSPECTION COMPLETED:
12:00 PM
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On 4/1/2025, Licensing Program Analyst (LPA), Crystal Ali met with Applicant for the purpose of conducting a Pre-Licensing Inspection. Applicant is requesting to provide care and supervision for a Large Family Child Care Home for the capacity of 14 children. Currently residing in the home is the applicant, applicants’ husband, one adult child and one minor child. All adults residing in the home have a Criminal Record Clearance (DOJ/FBI and Child Abuse Index Clearance). Applicant and LPA toured the home indoors and outdoors to ensure the home meets licensing requirements. Applicant is requesting the days and hours of operation will be: 8:00 AM to 5:00 PM, Monday through Friday. Applicant wants to only care for children ages 2 to 12. Applicant stated that she does not have an assistant at this time and that once she is approved licensed daycare then she will hire an assistant prior to her exceeding capacity requirements of a small family daycare.
NAME OF LICENSING PROGRAM MANAGER: Claretta Yates
NAME OF LICENSING PROGRAM ANALYST: Crystal Ali
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 04/01/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/01/2025
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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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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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
PALMDALE CC RO, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: MARDOYAN FAMILY CHILD CARE
FACILITY NUMBER: 197700921
VISIT DATE: 04/01/2025
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Physical Plant: This is a single-story home with three bedrooms and three bathrooms, a kitchen, living room, dining room, family room, laundry, large front yard, large backyard, and garage. The home is inspected for safety, comfort, cleanliness, telephone service, and proper ventilation. There is no landline phone. Applicant will utilize her cell phone for daycare business. The home has central heating and air conditioning. All windows are free of cracks, bugs, and debris. The fireplace is located in the main childcare room and is inaccessible to children. The kitchen was inspected for hazardous or dangerous items. The sharp utensils and knives are stored top drawers on opposite sides of kitchen near refrigerator and oven inaccessible to children. Alcohol is located near kitchen table (that seats four) that is accessible to children. Applicant stated she will place safety latch on the cabinet to make it inaccessible to children. The refrigerator/freezer (2) are both working located in kitchen and laundry room. Detergents/cleaning compounds are kept in the hallway cabinet outside of daycare bathroom that is inaccessible to children. Medications will be stored in the hallway second drawer towards the laundry room inaccessible to children. Applicant stated that she will have a camera locate at the front door facing the main childcare room only. This camera video system will hold only 10 hours of film at a time and then automatically erases the footage.

Childcare Area: Per Applicant, the kitchen, dining room (main childcare room), family room, bathroom #1 and backyard are the daycare areas. The main childcare room has dining/seating for at least twelve small children and the kitchen table has room for four more children. LPA observed age-appropriate furniture, toys, and books for the children. Toys and books are stored in the cabinets in the main childcare room. LPA observed napping cots (6).

NAME OF LICENSING PROGRAM MANAGER: Claretta Yates
NAME OF LICENSING PROGRAM ANALYST: Crystal Ali
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 04/01/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/01/2025
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
PALMDALE CC RO, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: MARDOYAN FAMILY CHILD CARE
FACILITY NUMBER: 197700921
VISIT DATE: 04/01/2025
NARRATIVE
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 All unused electrical outlets are covered in the on-limit areas. The isolation area is in the family room, child will use the couch away from main childcare room to rest until parents come to pick them up. Blinds are on all windows but there are no cords.

Bathroom #1- The bathroom (in the hallway near laundry room) was toured and inspected the sink/toilet are operable. The bathroom has a toilet, sink and shower. The shower is safety latched. The bathroom was clean, sanitized and in good repair. LPA observed one potty-training toilet.

Fire extinguisher was present on the wall to the left once you enter the kitchen from the main entrance of home. LPA observed a new fire extinguisher that is in the green. Smoke and carbon monoxide detectors were found to be in compliance per Fire Marshall Standards. Fire Marshall approved the home on 3/18/25. One First Aid Kit and CPR mask observed by LPA in the daycare bathroom located above the toilet inaccessible to children. LPA observed Fire blanket next to fire extinguisher. LPA observed that Applicant has an anti-choke device located next to the first aid kit. LPA recommend single action door handles for both emergency exits.

Transportation will mainly be provided for school age kids. Applicant stated that she will only pick up kids from school and transport them to her daycare. Applicant stated that there is an elementary school located in walking distance from her home. LPA verified driver’s license and car insurance.

NAME OF LICENSING PROGRAM MANAGER: Claretta Yates
NAME OF LICENSING PROGRAM ANALYST: Crystal Ali
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 04/01/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/01/2025
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
PALMDALE CC RO, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: MARDOYAN FAMILY CHILD CARE
FACILITY NUMBER: 197700921
VISIT DATE: 04/01/2025
NARRATIVE
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Outside: The backyard was inspected. The backyard is fenced all around. The sides of back yard on the right and left are off-limits. The center of the backyard is on-limits for children’s play. There is a large play area with two tables, three other play equipment, one shaded area, and soil area for plant activities. There are two small sheds in back yard that are inaccessible to children. The front yard is off limits to the children. Applicant states parents will escort their children to the front door to enter the daycare. LPA observed front yard and back yard to have no sharps items or hazards materials.

There are no pets in the home. Applicant states that there are no bodies of water, no weapons/firearms, and no smoking on the premises.

Off Limit Areas: Master Bedroom and bathroom #3, Bedroom #2-#3, Bathroom #2, laundry room, garage, and front yard. All off-limit rooms have safety knobs on them except for the master bedroom. Applicant stated that she will place safety latch on the master bedroom door. LPA observed the garage is not accessible from inside the home.

LPA received the following: Current Pediatric CPR/First Aid. Preventive Health and Safety Training, Mandated Reporter, and Immunizations for TDAP. Postings: Emergency Disaster Plan, Earthquake Preparedness Checklist, and Notification of Parent's Rights. LPAs did not observe a parent board with the required documentation. The Safe Sleeping Regulation was shared with the Applicant. Incidental Medical Services (IMS) policy was discussed.

NAME OF LICENSING PROGRAM MANAGER: Claretta Yates
NAME OF LICENSING PROGRAM ANALYST: Crystal Ali
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 04/01/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/01/2025
LIC809 (FAS) - (06/04)
Page: 5 of 10
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
PALMDALE CC RO, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: MARDOYAN FAMILY CHILD CARE
FACILITY NUMBER: 197700921
VISIT DATE: 04/01/2025
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The following information was discussed with the Applicant:

Maintain mandatory forms for the children’s files and provider’s files. Requirements for disaster drills (fire and earthquake) and documentation for both. The applicant is reminded that 100% supervision is always required for all children. Maintain capacity limits, parent/child roster maintenance, posting facility license, knowledge of Emergency Plan. All food is properly labeled if brought from child’s home; and all food is checked periodically for expiration dates. Applicant was advised how to access forms and Regulations for Family Child Care online at: www.ccld.ca.gov. Applicant was made aware that it is their responsibility to know the regulations as well as anyone who assists in providing care. Applicant was advised that inaccessibility of hazards must be constantly reassessed depending on the children in care. Licensing must always have the facility’s phone number; if the phone number is changed, licensing must be notified. A licensed childcare provider, administrator, or employee of the licensed child day care facility shall complete an on-line Mandated Reporter Training and shall renew the training every two (2) year at: www.mandatedreporterca.com. Applicant was advised of the requirement to report unusual incidents and/or injuries to the parent/guardian and Licensing within the time frame specified by the regulation and on the form (LIC 624B). www.unusualincidentreport@dss.ca.gov. The applicant was informed of the responsibility to report suspected Child Abuse by calling the Child Abuse Hot line at 1-800-540-4000. Also, call the CCLD office and follow up with a written Unusual Incident/Injury Report (LIC 624B). Criminal Record Statement: Applicant 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 the initial presence in a licensed Family Child Care Home.

NAME OF LICENSING PROGRAM MANAGER: Claretta Yates
NAME OF LICENSING PROGRAM ANALYST: Crystal Ali
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 04/01/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/01/2025
LIC809 (FAS) - (06/04)
Page: 6 of 10
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
PALMDALE CC RO, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: MARDOYAN FAMILY CHILD CARE
FACILITY NUMBER: 197700921
VISIT DATE: 04/01/2025
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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. Safe Sleep: LPA discussed the safe sleep regulations with applicant 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 applicant 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. Notice of Site Visit: A notice of site visit must remain posted for 30 days. Posting Requirements: Failure to comply with posting requirements shall result in an immediate civil penalty of $100.00. Parent Notifications Requirements: Per the Health and Safety code (HSC) 1596.859, 1596.8895, and 1597.05 to improve transparency of licensing records and to ensure that the parents/guardians using the licensed childcare facility are aware of situations that present danger to the children.

Employees or volunteers at family day care home; immunization requirements; records; exemptions (1) Commencing September 1, 2016, a person shall not be employed or volunteer at a family day care home if he or she has not been immunized against Influenza, Pertussis, Rubella, Mumps, and Measles. Each employee and volunteer shall receive an Influenza vaccination between August 1 and December 1 of each year. Type

NAME OF LICENSING PROGRAM MANAGER: Claretta Yates
NAME OF LICENSING PROGRAM ANALYST: Crystal Ali
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 04/01/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/01/2025
LIC809 (FAS) - (06/04)
Page: 7 of 10
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
PALMDALE CC RO, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: MARDOYAN FAMILY CHILD CARE
FACILITY NUMBER: 197700921
VISIT DATE: 04/01/2025
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A citation: Type A citation(s) shall be posted for 30 consecutive days along with the Notice of Site Visit Letter (printed out after every visit) and posted during hours of operation, as there is/are immediate risk(s) to the health, safety, or personal rights of children in care. Applicant shall provide a copy any Type A citation(s) to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child’s file for verification. Failure to do so will result in a Civil Penalty being assessed. The regulation prohibits the smoking of tobacco in a private residence that is licensed as a family childcare home and in those areas of the family day care home where children are present (24/7 ban). State law prohibits baby walkers, bouncy seats, exer-saucers, and any other items that fall into that category. Applicant was advised to visit the CCL website (www.ccld.ca.gov) to obtain updates of courses and updates/changes to the regulations.

Our Quarterly updates come out every 3 months they are also now in Spanish please log in to the CCLD website or you can email our advocates to have the quarterly updates sent directly to your email. Child Care Advocates information: www.childcareadvocatesprogram@cdss.ca.gov.

The On Duty Worker is available for questions Monday through Friday at (661) 202-3318 from 8:00 AM - 5:00 PM for questions, information, and Unusual Incident Reporting.

A copy of the Safe Sleep Proposed Regulations was provided to the Applicant.

NAME OF LICENSING PROGRAM MANAGER: Claretta Yates
NAME OF LICENSING PROGRAM ANALYST: Crystal Ali
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 04/01/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/01/2025
LIC809 (FAS) - (06/04)
Page: 8 of 10
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
PALMDALE CC RO, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: MARDOYAN FAMILY CHILD CARE
FACILITY NUMBER: 197700921
VISIT DATE: 04/01/2025
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Incidental Medical Services (IMS) policy was discussed. Applicant will wait until facility opens to determine IMS needs. 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.htmSafe Sleep in Child Care: Resources can be found on our website at http://www.cdss.ga.gov/inforesources/Child-Care-Licensing/Public-Information-and-Resources/Safe-SleepLead Poisoning: For more information, go to the California Childhood Lead Poisoning Prevention Branch’s website at www.cdph.ca.gov/programs/clppb,or call them at (510) 620-5600.

Applicant advised visit www.shotsforschool.org for Immunization information.

Child Care Advocates: You can now sign up for Quarterly Updates and PINs for one or more programs through our DSS website at www.ccld.ca.gov. Click on “Receive Important Updates” located in the right middle part of the page, immediately above the Quick links. Put your email address and choose which program(s) you would like to subscribe to and click “subscribe”.

NAME OF LICENSING PROGRAM MANAGER: Claretta Yates
NAME OF LICENSING PROGRAM ANALYST: Crystal Ali
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 04/01/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/01/2025
LIC809 (FAS) - (06/04)
Page: 9 of 10
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
PALMDALE CC RO, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: MARDOYAN FAMILY CHILD CARE
FACILITY NUMBER: 197700921
VISIT DATE: 04/01/2025
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 Prior to being licensed, the following corrections are required by: April 3, 2025
· Master bedroom- safety latch on door.
. Kitchen- safety latch on cabinet that houses alcohol near the kitchen table.

As a result of this inspection, corrections are needed before a childcare license cannot be issued, per Title 22 regulations. An Exit interview was conducted: A copy of this report was read, and provided to Tamara Mardoyan, Applicant.
NAME OF LICENSING PROGRAM MANAGER: Claretta Yates
NAME OF LICENSING PROGRAM ANALYST: Crystal Ali
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 04/01/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/01/2025
LIC809 (FAS) - (06/04)
Page: 10 of 10