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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198019275
Report Date: 07/16/2024
Date Signed: 07/16/2024 04:07:36 PM

Document Has Been Signed on 07/16/2024 04:07 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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:SIMONYAN FAMILY CHILD CAREFACILITY NUMBER:
198019275
ADMINISTRATOR/
DIRECTOR:		SIMONYAN, DAVITFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(818) 818-2875
CITY:BURBANKSTATE: CAZIP CODE:
91506
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 9DATE:
07/16/2024
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:35 PM
MET WITH:Sirvard Ohanyan, Facility Representative TIME VISIT/
INSPECTION COMPLETED:
04:15 PM
NARRATIVE
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Licensing Program Analysts (LPAs) Lilia Hernandez and Roberto Luque Avila conducted an unannounced annual required - 3 year inspection to the above facility on 07/16/2024. LPAs arrived at the facility at 2:35PM, identified self and met with Sirvard Ohanyan, Licensee Representative, who guided LPAs on a tour of the facility. Licensee was not present during the inspection. LPAs provided Licensee Representative with a copy of the LIC 126 Entrance Checklist to help facilitate the inspection.
Capacity as specified on the license is being maintained.

LPAs observed 3 infants and 6 children present upon arrival. There was also Staff #1 and adult relative associated to the home present.

Licensee Representative 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.

Facility operation hours are Monday to Friday from 7:30AM-5:30PM.

The family child care home is a 3 bedrooms, 2.5 bathrooms, living room, dining room, kitchen and family room. Current facility sketch reviewed, and Licensee Representative confirmed that the family room and bathroom located in the family room are used for providing care and are accessible to children. All other rooms are off-limits and made inaccessible by use of locked doors. ---Page 1 of 3
SUPERVISORS NAME: Rita Ramos
LICENSING EVALUATOR NAME: Lilia Hernandez
LICENSING EVALUATOR SIGNATURE: DATE: 07/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/16/2024
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 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: SIMONYAN FAMILY CHILD CARE
FACILITY NUMBER: 198019275
VISIT DATE: 07/16/2024
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Per Licensee Representative, there are no firearms or weapons on the premises. All poisons are kept in a locked storage area. No poisons were observed during the inspection. Detergents, cleaning compounds, medication and other hazardous items are made inaccessible.

There is a working fire extinguisher that was purchased on 08/07/2023. LPAs observed a smoke detector and carbon monoxide detector in the home that were tested and operable. LPAs also observed adequate heating and ventilation for safety and comfort.
An emergency fire/disaster drill was completed within the last 6 months. Last documented fire/disaster drill was on 07/05/2024.

There are currently 3 infants in care.
LPAs discussed the safe sleep regulations with Licensee Representative 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.

LPAs also informed Licensee Representative 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.

Licensee Representative was reminded that children in care are to be supervised at all times and made aware that children shall not be left in parked vehicles. Car seats are used for transportation purposes only and are not used for sleeping children.

The outdoor area accessible to children is the back yard. All other outdoor areas are inaccessible by a gate with a lock. LPAs observed no swimming pool or other bodies of water on the premises.

LPAs reviewed a sample of children’s files and observed files were complete. Licensee has a current roster of the children enrolled. ---Page 2 of 3
SUPERVISORS NAME: Rita Ramos
LICENSING EVALUATOR NAME: Lilia Hernandez
LICENSING EVALUATOR SIGNATURE:

DATE: 07/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/16/2024
LIC809 (FAS) - (06/04)
Page: 2 of 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: SIMONYAN FAMILY CHILD CARE
FACILITY NUMBER: 198019275
VISIT DATE: 07/16/2024
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Staff records were reviewed for approved Pediatric First Aid and CPR certification, LIC 9052- Employee Rights, Proof of immunizations against measles, pertussis and influenza or influenza declination, TB clearance or risk assessment, LIC 9108- Statement Acknowledging Requirement to Report Child Abuse and current Mandated Reporter Training Certificate. Licensee’s Mandated Reporter Training was completed on 07/01/2024. Licensee’s pediatric CPR/First Aid expires on 06/14/2023.
Licensee Representative pediatric CPR/First Aid expires on 06/14/2023.

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 Representative 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.
There were no deficiencies cited during today’s visit.

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

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

Exit interview conducted and report was reviewed with the Sirvard Ohanyan, Licensee Representative.
---Page 3 of 3
SUPERVISORS NAME: Rita Ramos
LICENSING EVALUATOR NAME: Lilia Hernandez
LICENSING EVALUATOR SIGNATURE:

DATE: 07/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/16/2024
LIC809 (FAS) - (06/04)
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