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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198012716
Report Date: 06/19/2026
Date Signed: 06/19/2026 12:56:52 PM

Document Has Been Signed on 06/19/2026 12:56 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
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:KOSTANDYAN FAMILY CHILD CAREFACILITY NUMBER:
198012716
ADMINISTRATOR/
DIRECTOR:		KOSTANDYAN, KARINEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(323) 665-7713
CITY:LOS ANGELESSTATE: CAZIP CODE:
90029
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 12DATE:
06/19/2026
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:55 AM
MET WITH:Arakysay Hakobyan, Assistant
Zaruhi Kostandyan, Assistant		TIME VISIT/
INSPECTION COMPLETED:
01:30 PM
NARRATIVE
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On Friday June 19, 2026, Licensing Program Analyst (LPA) Joanne Solorio Campos conducted an unannounced annual inspection and met with Licensee’s assistants, Araksya and Zaruhi, whom the purpose of the visit was explained, and guided LPA Solorio Campos on a tour of the facility. Licensee was not initially present. LPA arrived to the facility as the Licensee was driving off due to an emergency. Licensee arrived shortly before LPA concluded the inspection. LPA observed 12 children present. LPA observed facility to be within ratio. Operating hours are Monday to Friday from 8:00a.m-12:00am and care for children ages 0 to 13 years old. Licensee stated she has 14 children enrolled.

This is a one-story home which consists of 3 bedrooms, 2 bathrooms, kitchen, dining room, living room, basement and front and backyard(fenced). The children use the two bathrooms, the living room, dining room and two bedrooms. Per licensee, areas off limits to children include: 1 bedroom and part of the backyard, which is separated by a fence from the children’s yard and the basement which has a locked door in place. Family members residing in the home are cleared (criminal record clearances on file). The LPA toured all areas used by children during this visit.

LPA Solorio Campos provided Licensee with LIC926 entrance checklist and observed the following required postings in the entry way of the facility; License, LIC 9148 Earthquake Preparedness Checklist, LIC 610A Emergency Disaster Plan, Pub 394 Notification of Parents Rights, and LIC 999 Facility sketch.
NAME OF LICENSING PROGRAM MANAGER: Katrina Chicote
NAME OF LICENSING PROGRAM ANALYST: Joanne Solorio Campos
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 06/19/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/19/2026
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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Document Has Been Signed on 06/19/2026 12:56 PM - It Cannot Be Edited


Created By: Joanne Solorio Campos On 06/19/2026 at 12:34 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: KOSTANDYAN FAMILY CHILD CARE
FACILITY NUMBER: 198012716

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/19/2026

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1596.8662(b)(1)
Administration of Child Day Care Licensing
(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, interview, record review, the licensee did not comply with the section cited above in 1 staff did not have a current training, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 07/24/2026
Plan of Correction
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Licensee will provide completed certification by POC due date.
Type B
Section Cited
CCR
102416(c)
Personnel Requirements
(c) The licensee and other personnel as specified shall complete training on preventive health practices, including pediatric cardiopulmonary resuscitation and pediatric first aid, pursuant to Health and Safety Code Section 1596.866.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, interview, record review, the licensee did not comply with the section cited above in 2 staff not having a current certification, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 07/24/2026
Plan of Correction
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LIcensee will provide completed certification by POC due date.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Katrina Chicote
NAME OF LICENSING PROGRAM MANAGER:
Joanne Solorio Campos
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 06/19/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/19/2026


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
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: KOSTANDYAN FAMILY CHILD CARE
FACILITY NUMBER: 198012716
VISIT DATE: 06/19/2026
NARRATIVE
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LPA Solorio Campos asked the Assistant Araksya if there were any pets, poisons, firearms, or weapons, or bodies of water and the Licensee stated they do not have any of the above-mentioned and LPA did not observe any. The licensee was informed that if any poisons (ex; drano, rat poison or items that fall into that category), firearms and weapons are purchased, it is required to be locked with a key or combination lock, and firearm and ammunition must be stored separately.

LPA inspected the facility for safety, comfort, cleanliness, ventilation and working phone (cell phone and landline). For ventilation, LPA observed central a/c and vents located in the ceiling. LPA observed the furniture, a piano, manipulatives, Lego table, books, blocks, puzzles, art materials and other age-appropriate materials that were well maintained and free of loose, sharp, and pointed parts. LPA observed cots as napping equipment for children and each with an individual tight-fitted sheet stored separately for each child.
LPA observed cleaning compounds items, stored underneath the kitchen sink, and observed a childproof lock in place, making it inaccessible for children to open. LPA observed the knives and sharp objects stored inside a drawer and made inaccessible for children to open.

The Assistant stated the facility provides breakfast, am snack, lunch, and dinner. LPA informed licensee that any food brought from the children's homes, the container shall be labeled with the child's name and properly stored or refrigerated. For water drinking, assistant stated they provide water via filtered water. Licensee stated she currently does not have any children with severe food allergies nor on medication.



LPA Solorio Campos entered the bathrooms and observed a working toilet, working sink with hand soap. LPA reminded licensee that personal items (ex; shampoo, toothpaste, mouthwash, or items that fall into that category) must be made inaccessible to children.

LPA toured the outdoor area. LPA observed the play area to have perimeter fencing throughout. LPA observed age-appropriate toys, tricycles, and play sets free of loose and sharp parts available for the children. The climbing structures are surrounded by material that can absorb a fall. LPA observed adequate shade via canopies.
NAME OF LICENSING PROGRAM MANAGER: Katrina Chicote
NAME OF LICENSING PROGRAM ANALYST: Joanne Solorio Campos
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 06/19/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/19/2026
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
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: KOSTANDYAN FAMILY CHILD CARE
FACILITY NUMBER: 198012716
VISIT DATE: 06/19/2026
NARRATIVE
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At time of inspection, LPA Solorio Campos observed the required 2A10BC fire extinguisher located in the kitchen and the valve on the green area indicating fully charged and last serviced on 06/10/26. LPA observed a carbon monoxide detector and smoke alarm combined and located in the living room and throughout the home and were operable. LPA observed the first aid kit in the hallway to be complete with band aids, gauzes, adhesive bandages, antiseptic wipes and scissors. For ill isolation, Assistant stated she utilizes the table near the front door of the living room . LPA observed the last emergency drill conducted on 04/27/26.

LPA Solorio Campos observed licensee’s Red Cross Pediatric First Aid/ CPR certification and expires 06/2027, and licensee has proof of immunization against Pertussis, MMR, and Influenza declination. Licensee has completed the Child Abuse Mandated Reporter (AB 1207) training and expires 11/26/26. Licensee was advised that the mandated reporter training must be completed every 2 years, and is available at www.mandatedreporterca.com

LPA also reviewed children’s roster, children files including sleep logs and assistant files. LPA observed the files to be incomplete as two Staff had an expired CPR/First Aid Certification and they were left alone with the children, this poses a potential health and safety risk to the children in care. LPA also observed one staff to not have a current Mandated Reporter Training, which poses a potential health and safety risk to the children in care.

Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

LPA discussed the safe sleep regulations with licensee’s assistant and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep as an additional resource. LPA also informed Licensee of the importance of checking for and removing any 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.
NAME OF LICENSING PROGRAM MANAGER: Katrina Chicote
NAME OF LICENSING PROGRAM ANALYST: Joanne Solorio Campos
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 06/19/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/19/2026
LIC809 (FAS) - (06/04)
Page: 5 of 6
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: KOSTANDYAN FAMILY CHILD CARE
FACILITY NUMBER: 198012716
VISIT DATE: 06/19/2026
NARRATIVE
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Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22- 02-CCP. 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: https://www.ada.gov/resources/child-care-centers/.

Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California

To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

During the exit interview, Licensee confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

At this time, the licensee is in compliance with California Title 22 Regulations. Therefore, there are no citations being issued today.



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

Exit interview conducted and report was reviewed with the Licensee Karine Kostandyan.
NAME OF LICENSING PROGRAM MANAGER: Katrina Chicote
NAME OF LICENSING PROGRAM ANALYST: Joanne Solorio Campos
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 06/19/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/19/2026
LIC809 (FAS) - (06/04)
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