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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198017917
Report Date: 12/03/2024
Date Signed: 12/03/2024 11:36:40 AM

Document Has Been Signed on 12/03/2024 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
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:TADEVOSYAN FAMILY CHILD CAREFACILITY NUMBER:
198017917
ADMINISTRATOR/
DIRECTOR:		TADEVOSYAN, TATEVIKFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(818) 502-0172
CITY:GLENDALESTATE: CAZIP CODE:
91203
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 9DATE:
12/03/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:46 AM
MET WITH:Tatevik Tadevosyan TIME VISIT/
INSPECTION COMPLETED:
11:46 AM
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 12/03/2024, at 10:45 am , Licensing Program Analyst(LPA) Shushanik Safaryan conducted an unannounced Case Management inspection to the above facility to ensure Type A deficiency cited on 11/19/2024 have been cleared.
Upon arrival, LPA met with Facility Representative , Tatevik Tadevosyan , to whom the reason of the visit was explained . Tour was provided . During the tour , LPA observed 9 children with an assistant Lilit Shahbandaryan and licensee.

On 11/19/2024, deficiency was cited for having 14 children under age of 6 present in the facility. Per licensee 2 children were disenrolled and updated children roster was available for review . LPA reviewed children roster and observed 2 children under age of 6 disenrolled with effective date 11/20/2024. During today’s visit, LPA toured the facility and observed 9 children present under age of 6 .

During the visit, LPA cleared deficiency cited on 11/19/2024 and provided a copy of the Licensing Report to Licensee and issued POC clearance letter.

The Notice of Site Visit (LIC 9213) was given and must remain posted for 30 days.

Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

End of the report
SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Shushanik Safaryan
LICENSING EVALUATOR SIGNATURE: DATE: 12/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/03/2024
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 1