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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198017226
Report Date: 03/06/2025
Date Signed: 03/06/2025 11:36:02 AM

Document Has Been Signed on 03/06/2025 11:36 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
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:MAMBREIAN FAMILY CHILD CAREFACILITY NUMBER:
198017226
ADMINISTRATOR/
DIRECTOR:		MAMBREIAN, VARDOUIFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(323) 663-6625
CITY:LOS ANGELESSTATE: CAZIP CODE:
90027
CAPACITY: 14TOTAL ENROLLED CHILDREN: 9CENSUS: 8DATE:
03/06/2025
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:40 AM
MET WITH:Vardoui Mambreian, LicenseeTIME VISIT/
INSPECTION COMPLETED:
11:30 AM
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Licensing Program Analyst (LPA) Anomeh Eivazian conducted an unannounced required- 3 year inspection to the above facility on 03/06/25. LPA arrived at the facility at 8:40 AM and met with Vardoui Mambreian, Licensee who guided analyst on a tour of the facility. Also present during this inspection, were licensee's assistant, Madlen Nazarian, Ripsime Mambreian, licensee's mother and Anahit Mambreian, licensee's sister. Per licensee, Vardoui Mambreian facility hours are Monday to Friday from 8:30 a.m. to 3:00 p.m. LPA provided licensee a copy of Entrance Check List-Family Child Care Home (LIC 126) at 11:20 a.m..

This is a one story home which consists of 2 bedrooms, 2 bathrooms, kitchen, dining room, living room, family room, converted garage (1 room, 1 bathroom and storage), music room, laundry room, front yard and backyard (fenced).

The children use the living room, dining room, bathroom in the hallway, and backyard (fenced). Per licensee, areas off limits to children and parents include: 2 bedrooms, 1 bathroom, family room, kitchen, music room, laundry room, front yard and converted garage. Per licensee, parents enter the home through the main entrance which leads to the living room. During this inspection individuals who reside in the home were discussed and notes on Confidential Name List (LIC811) and attached to this report.

All areas identified on the facility sketch that are accessible for children to use were inspected for safety, comfort, and cleanliness. At 9:00 am., Licensee took this LPA on a tour of the home. LPA was toured through the interior starting with the living room and dining room (daycare classrooms), LPA observed sofas, children tables, chairs and toys in the living room. LPA observed an adult dining table and chairs in the dining room. LPA observed all electrical outlets were covered in living room and dining room. There is a fireplace in the living room which has been blocked off to prevent access. Next LPA toured the family room and observed sofas, a coffee table and a TV in the family room. Next LPA toured the daycare bathroom in the hallway of bedrooms and did not observe any hazards. LPA observed licensee's and her family members personal belongings in the home. During this inspection LPA observed off-limit areas door were closed to prevent access.
REPORT CONTINUES ON NEXT PAGE 1 of 4
SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Anomeh Eivazian
LICENSING EVALUATOR SIGNATURE: DATE: 03/06/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/06/2025
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: MAMBREIAN FAMILY CHILD CARE
FACILITY NUMBER: 198017226
VISIT DATE: 03/06/2025
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LPA observed the required 2A 10BC fire extinguisher was placed on the floor in he dining room. Per licenee it was purchased 12/2024 but she was not able to locate the receipt. Licensee tested the carbon monoxide and smoke detectors in the family room. It sounded off the alarms and heard by LPA to be functional. Detergents, cleaning compounds, medications, and other items which could pose a danger to children were observed to be inaccessible to children. The licensee states that there are no poisons in the home and understands that storage areas for poisons must be locked with a key or combination lock.

Next LPA toured the backyard fenced. Currently, children are using the back yard for outdoor play time. The outdoor play area was observed to be fenced. Per licensee, children go to the backyard through side yard. LPA observed that the outdoor yard has toys and other materials for children to play with. LPA observe a lattice was placed by the stairs which leads to the kitchen. Per licensee, when children come backyard for play, she will put the lattice by the stairs to make it inaccessible the children. LPA did not observe any objects that can pose a danger to children on the outdoor yard. The licensee states that supervision is always provided.

Per Licensee, at 9;45 a.m there are no weapons, firearms, pools, spas, hot tubs, fish ponds, or similar bodies of water on the premises. There is a dog on the premises which is inaccessible to the children. Per licensee, she provided AM and PM snacks, children bring their own lunch.

The licensee was observed to be operating within the licensed capacity and is not exceeding the required limitations during this inspection. During this inspection 9 children were present in the facility, three being under 2 years old with licensee and her assistant. All adults present have obtained a criminal record clearance on Licensing Information System (LIS). Per licensee, currently she does not have assistant. Licensee 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 initial presence in a licensed Family Child Care Home. 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.

The licensee and other personnel have completed training on preventive health practices including Pediatric First Aid and CPR. The licensee's Pediatric First Aid and CPR expires on 06/2025.
REPORT CONTINUES ON NEXT PAGE 2 of 4
SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Anomeh Eivazian
LICENSING EVALUATOR SIGNATURE:

DATE: 03/06/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/06/2025
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
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: MAMBREIAN FAMILY CHILD CARE
FACILITY NUMBER: 198017226
VISIT DATE: 03/06/2025
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Licensee, did not have required mandated reporter training certificate available for review during this inspection. There are first aid supplies available on the premises in the kitchen. LPA advised licensee that if a child shows signs of illness he/she/they shall be separated from other children. At 10:10 a.m., facility roster was reviewed and not completed. Per licensee currently there are 9 children enrolled. LPA reviewed 5 children's records, including emergency information from 9 enrolled children, and all 5 reviewed files were completed. The licensee and her assistant have proof of immunization against influenza, pertussis, and measles.

All homes shall conduct fire and disaster drills at least once every six months, and document the date and time of each drill. Last drill documented was conducted on 02/21/25. Emergency Disaster Plan, Parent’s Rights Poster and the Facility License were observed to be posted at the wall in the dining room.

LPA did not observe the following items during the inspection: Infant Walkers, Johnny Jumpers, Saucer Chairs, Trampolines and/or any other item that fall into these categories are not permitted in a family child care facility. Smoking is prohibited in a licensed Family Child Care Home. Per Licensee, no one smokes in the home. There is telephone service via a landline that is used stays at the facility during operation hours.
Per licensee she does not carry liability insurance or a bond in accordance with standard established by Family Child Care statue. Signed statements (LIC282) on 5 reviewed files.

INFANT CARE: Licensee states that currently she has 3 infants over 12 months old enrolled in her daycare. Per licensee, she provides care to infants 12-24 months old. Licensee states the infant sleep in the daycare area where they are constantly supervised. Appropriate sleeping arrangements and cribs will be available. LPA advised the Licensee that infants shall be placed on their backs for sleeping and shall be supervised. Infants shall be checked on every 15 minutes and the time of each 15-minute check shall be documented with child’s name and date. The LIC 9227 Individual Infant Sleeping Plan shall be completed for each infant up to 12 months of age. A copy of the LIC 9227 was provided to Licensee. Licensee did not have 15 minutes check documentation during this inspection. Per licensee, while children all napping either licensee or her assistant stays in the room with chidlren.
REPORT CONTINUES ON NEXT PAGE 3 of 4
SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Anomeh Eivazian
LICENSING EVALUATOR SIGNATURE:

DATE: 03/06/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/06/2025
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
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: MAMBREIAN FAMILY CHILD CARE
FACILITY NUMBER: 198017226
VISIT DATE: 03/06/2025
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SAFE SLEEP: LPA discussed the safe sleep regulations with licensee, and discussed the Child Care Licensing Safe Sleep webpage at http://www.cdss.ca.gov/inforescources/child-care-licensing/public-information-and-resoucrces/safe-sleep as an additional resource. LPA also informed licensee of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at http://www/cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment. Boppy recall: https://www.cpsc.gov/Recalls/2021/The-Boppy-Company-Recalls-Over-3-Million-Original-Newborn-Loungers-Boppy-Preferred-Newborn-Loungers-and-Pottery-Barn-Kids-Boppy-Newborn-Loungers-After-8-Infant-Deaths-Suffocation-Risk

Medication: Incidental Medical Services (IMS) policy was discussed. The licensee states that she will provide IMS. Per licensee, there are no children enrolled that require IMS at this time. 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.

LPA advised the licensee to access forms, regulations and quarterly updates online at: www.ccld.ca.gov.
To improve the quality and value of the new inspection process, a survey will 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 tools, please send them by email 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/process.
A notice of site visit was given and must remain posted for 30 days.
Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
Licensee, Vardoui Mambreian 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.
During the exit interview, the Licensee, Vardoui Mambreian confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.
Exit interview conducted and report was reviewed with the licensee, Vardoui Mambreian.
REPORT END 4 of 4
SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Anomeh Eivazian
LICENSING EVALUATOR SIGNATURE:

DATE: 03/06/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/06/2025
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 03/06/2025 11:36 AM - It Cannot Be Edited


Created By: Anomeh Eivazian On 03/06/2025 at 10:22 AM
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: MAMBREIAN FAMILY CHILD CARE
FACILITY NUMBER: 198017226

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/06/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102425(j)(1)
Infant Safe Sleep
The provider shall supervise infants while they are sleeping and adhere to the following requirements: The provider shall physically check on the infant every 15 minutes.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on 5 children file review and licensee statement, the licensee did not comply with the section cited above, per licensee infants sleep in the living room under an adult supervision all the time but she did not document every 15 minutes which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 03/14/2025
Plan of Correction
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Per licensee, effective today she will start to document infants breathing and position every 15 minutes and will document it. LPA provided a copy of Infant Sleep Nap Chart to licensee.
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 licensee file review, the licensee did not comply with the section cited above and did not have required mandated reporter training certificate on file which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 03/14/2025
Plan of Correction
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Per Licensee, she will complete the required mandated reporter training and a copy of certificate will be submitted to LPA.
www.mandatedreporterca.com
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Christina Gabelman
LICENSING EVALUATOR NAME:Anomeh Eivazian
LICENSING EVALUATOR SIGNATURE:
DATE: 03/06/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/06/2025


LIC809 (FAS) - (06/04)
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