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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198018297
Report Date: 12/09/2024
Date Signed: 12/09/2024 02:52:56 PM

Document Has Been Signed on 12/09/2024 02:52 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
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:GALSTYAN FAMILY CHILD CAREFACILITY NUMBER:
198018297
ADMINISTRATOR/
DIRECTOR:		GALSTYAN, ANNAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(818) 720-9137
CITY:GLENDALESTATE: CAZIP CODE:
91203
CAPACITY: 14TOTAL ENROLLED CHILDREN: 12CENSUS: 9DATE:
12/09/2024
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:03 AM
MET WITH:Anna Galstyan, LicenseeTIME VISIT/
INSPECTION COMPLETED:
02:50 PM
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ANNUAL INSPECTION CONDUCTED IN ARMENIAN
Licensing Program Analyst (LPA) Anomeh Eivazian conducted an unannounced required 3-year inspection to the above facility on 12/09/24. LPA arrived at the facility at 11:03 AM and met with Anna Galstyan, Licensee who guided analyst on a tour of the facility. Also present during this inspection, was Goharik Hakobyan, Licensee’s Assistant. Per licensee, facility hours are Monday to Friday from 7:00 a.m. to 10:00 p.m. LPA provided a copy of Entrance Checklist—Family Child Care Home (LIC126) to licensee.

This is a one story home located on the first level. The home consists of 3 bedrooms, 2 & 1/2 bathrooms, kitchen, dining room, living room, laundry room, front yard and backyard (fenced). Per licensee, parents enter the home through the main entrance which leads to the living room and side gate which leads to the backyard.

There is a detached unit in the backyard with separated address 406 W. Wilson Ave. #A, Glendale CA 91203. A copy of city permit on file. Licensee's daughter, Svetlana Bosnoyan applied for Family Child Care Home license for 406 W. Wilson Ave. #A, Glendale, CA 91203 with facility number 198021584.

Per licensee at 11:10 a.m. the children use the living room, dining room, one bedroom, one and half bathrooms, kitchen, and backyard (fenced). Per licensee areas off limits to children and parents include: Two bedrooms, one bathroom in the master bedroom, laundry room and front yard. LPA did not observe any stairs in the home. 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 11:10 a.m., Licensee took this LPA on a tour of the home. LPA was toured through the interior starting with the living room and dining room. LPA observed a TV, children's table, chairs and toys in the living room and dining room. LPA observed all electrical outlets were covered in living room
REPORT CONTINUES ON NEXT PAGE 1 of 6
Christina GabelmanTELEPHONE: (323) 981-3380
Anomeh EivazianTELEPHONE: (323) 981-3391
DATE: 12/09/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/09/2024
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: GALSTYAN FAMILY CHILD CARE
FACILITY NUMBER: 198018297
VISIT DATE: 12/09/2024
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and dining room. Next LPA toured the two off-limit bedrooms and one bathroom in master bedroom and did not observe any hazards. Next LPA toured the one bathroom in the hallway of bedrooms and observed child proof safety latches on the cabinet under the sink where licensee stores cleaning compounds. Next LPA toured the daycare bedroom and observed children napping cots in the bedroom. Next LPA toured the half bathroom in daycare bedroom and did not observe any hazards. Next LPA toured the kitchen and observed child proof safety latches on the cabinets where licensee stores sharp items and cleaning compounds. Per licensee children walk through the kitchen to go to the back yard. LPA observed the required 2A 10BC fire extinguisher was anchored to the wall in the kitchen. It was serviced on 08/23/24 as read by LPA from the service tag. Licensee tested the carbon monoxide and smoke detectors in the living room. Both 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. LPA observed that the outdoor yard has toys and other materials for children to play with. 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. LPA observed backyard was separated from the 406 W. Wilson Ave, #A, Glendale, CA 91203, with six feet high mesh fencing.

Per licensee, Anna Galstyan she will use the backyard on a staggered schedule with her daughter, Svetlana Bosnoyan, 198021584. Per licensee, her daughter, Svetlana Bosnoyan will use the front yard from 10:00 AM to 11:00 PM, and licensee, Anna Galstyan, will use the yard from 11:00 AM to 12:00 PM. Per licensee, her daycare children will not commingle with her daughter's daycare children at anytime.

Per Licensee, Anna Galstyan at 9:30 a.m. there are no pets, weapons, firearms, pools, spas, hot tubs, fish ponds, or similar bodies of water on the premises. Per licensee, she works with Food program. Per licensee, she does not provide transportation.

The licensee was observed to be operating within the licensed capacity and is not exceeding the required limitations during this inspection. During this inspection LPA observed 9 children were playing outside with licensee and her assistant.
REPORT CONTINUES ON NEXT PAGE 2 of 6
SUPERVISOR'S NAME: Christina GabelmanTELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Anomeh EivazianTELEPHONE: (323) 981-3391
LICENSING EVALUATOR SIGNATURE:

DATE: 12/09/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/09/2024
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: GALSTYAN FAMILY CHILD CARE
FACILITY NUMBER: 198018297
VISIT DATE: 12/09/2024
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 All adults present have obtained a criminal record clearance on Licensing Information System (LIS). Per licensee, currently she has two assistants. 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 04/25. Licensee, Anna Galstyan completed required mandated reporter training on 05/07/2022 and it was expired on 05/07/2024. 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 12:00 p.m., facility roster was reviewed and completed. Per licensee currently there are 12 children enrolled. LPA reviewed 5 children's records, including emergency information from 12 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 11/15/24. Emergency Disaster Plan, Parent’s Rights Poster and the Facility License were observed to be posted at the wall in the daycare bedroom.

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 cellphone that is used and the cellphone 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.
REPORT CONTINUES ON NEXT PAGE 3 of 6
SUPERVISOR'S NAME: Christina GabelmanTELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Anomeh EivazianTELEPHONE: (323) 981-3391
LICENSING EVALUATOR SIGNATURE:

DATE: 12/09/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/09/2024
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: GALSTYAN FAMILY CHILD CARE
FACILITY NUMBER: 198018297
VISIT DATE: 12/09/2024
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INFANT CARE: Licensee states that she is caring for infants over one year old. Per licensee, currently she does not have any infants enrolled in her daycare. Licensee states that infants sleep in the dining room and daycare bedroom where they are constantly supervised. 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.

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.
REPORT CONTINUES ON NEXT PAGE 4 of 6
SUPERVISOR'S NAME: Christina GabelmanTELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Anomeh EivazianTELEPHONE: (323) 981-3391
LICENSING EVALUATOR SIGNATURE:

DATE: 12/09/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/09/2024
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
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: GALSTYAN FAMILY CHILD CARE
FACILITY NUMBER: 198018297
VISIT DATE: 12/09/2024
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LPA Eivazian reviewed and discussed with the licensee the following Title 22 Regulations to ensure licensee will maintain compliance and always meet the Title 22 regulations.

Provider must reside in the home where care is being provided:
Definitions--102352 -- "Family Day Care" or "Family Child Care" means regularly provided care, protection, and supervision of children, in the care giver's own home, for periods of less than 24 hours per day, while the parents or authorized representatives are away. The term "Family Child Care" supersedes the term "Family Day Care" as used in previous regulations and "Home" means the licensee's residence as defined by Government Code Section 244.
Provider must be present 80% of the time providing care as stated in the following regulation:

Operation of a Family Child Care Home--102417 (a)-- The licensee shall be present in the home and shall ensure that children in care are supervised at all times. When circumstances require the licensee to be temporarily absent from the home, the licensee shall arrange for a substitute adult to care for and supervise the children during his/her absence. Temporary absences shall not exceed 20 percent of the hours that the facility is providing care per day.



Reporting Requirements--102416.2 (a) (2) --Any change in household composition including adults moving in or out of the home and anyone living in the home who reaches his or her 18th birthday.

Inspection Authority of the Department—102391 (a)--Any duly authorized officer, employee, or agent of the Department shall, upon presentation of proper identification, enter and inspect any place providing personal care, supervision, and services at any time, with or without advance notice, to secure compliance with, or to prevent a violation of, the regulations adopted by the Department governing family child care homes, and in accordance with Section 102396.

LPA Eivazian explained to the licensee that Licensee is required to operate separately from other providers regardless of family relationships. Licensee’s daughter, Svetlana Bosnoyan applied for a family childcare home license with facility number 198021584, for the ADU/ back housed located at 406 W. Wilson Avenue unit A, Glendale, CA 91203. LPA observed six feet high mesh fencing in the backyard to separate the licensee's home from her daughter's home.
REPORT CONTINUES ON NEXT PAGE 5 of 6
SUPERVISOR'S NAME: Christina GabelmanTELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Anomeh EivazianTELEPHONE: (323) 981-3391
LICENSING EVALUATOR SIGNATURE:

DATE: 12/09/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/09/2024
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: GALSTYAN FAMILY CHILD CARE
FACILITY NUMBER: 198018297
VISIT DATE: 12/09/2024
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The Department addressed the licensee requirement for enrolled children to be at this facility all the time during daycare hours. Enrolled children’s parents are required to be fully aware and clear on who is the licensee and caregiver to the children in care. Children are not allowed to go back and forth between licensee’s address and Bosnoyan daycare located at 406 W. Wilson Avenue unit A, Glendale, CA 91203. Per licensee, Anna Galstyan she will use the backyard on a staggered schedule with her daughter, Svetlana Bosnoyan, 198021584. Per licensee, her daughter, Svetlana Bosnoyan will use the front yard from 10:00 AM to 11:00 PM, and licensee, Anna Galstyan, will use the yard from 11:00 AM to 12:00 PM. Per licensee, her daycare children will not commingle with her daughter's daycare children at anytime. Co-mingling of children between the two separate licenses is a violation of Title 22 regulations.

Per licensee, Anna Galstyan facility Rosters and children's files for enrollment will be updated.
- Licensee will always interact with Department staff professionally and respectfully.
- Licensee understands that inspections are conducted in person, unannounced, and Department staff will be granted access to the facility as part of the inspection process.
- Licensee will be forthright with the department at all the times to ensure the health and safety of children in care.
- Licensee will be the main person to provide care to the children and interact with families.
Licensee submitted a written declaration signed and dated 12/09/24 that she will not comingle her day care children with Bosnoyan FCC, 198021584 daycare children at any time.

The following deficiencies listed on the attached LIC 809 (deficiency page) are being cited in accordance with California Code of Regulations Title 22. Deficiencies that are being cited need to be cleared to protect the children’s health & safety.

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.
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 experienced. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding inspection tools and methods, please visit the Program website at www.cdss.gov/inforesouces/community-care-liceinsing/inspection-process
Exit interview conducted and report was reviewed with the Licensee, Anna Galstyan.
REPORT END 6 of 6
SUPERVISOR'S NAME: Christina GabelmanTELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Anomeh EivazianTELEPHONE: (323) 981-3391
LICENSING EVALUATOR SIGNATURE:

DATE: 12/09/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/09/2024
LIC809 (FAS) - (06/04)
Page: 6 of 7
Document Has Been Signed on 12/09/2024 02:52 PM - It Cannot Be Edited

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: GALSTYAN FAMILY CHILD CARE
FACILITY NUMBER: 198018297

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/09/2024
DEFICIENCIES & PLANS OF CORRECTION (POCs)
Section Cited
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 her required mandated reporter training certificates was expired on 05/07/2024 which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 01/03/2025
Plan of Correction
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Per licensee, she will update her mandated reporter training and a copy of current certificate will be submitted to LPA via email by 01/03/25.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Christina GabelmanTELEPHONE: (323) 981-3380
Anomeh EivazianTELEPHONE: (323) 981-3391

DATE: 12/09/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/09/2024

LIC809 (FAS) - (06/04)
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