198019656-1-31-2022-33-CC-AEIN-CB7QYE-20220131113501

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198019656
Report Date: 01/31/2022
Date Signed: 01/31/2022 11:35:17 AM

Document Has Been Signed on 01/31/2022 11:35 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:	ZAKARYAN & KHACHYAN FAMILY CHILD CARE		FACILITY NUMBER:	198019656
ADMINISTRATOR:	V. ZAKARYAN & A. KHACHYAN		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(818) 484-8662
CITY:	GLENDALE	STATE: CA	ZIP CODE:	91202
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS: 7	DATE:	01/31/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Armen Khachyan and Varduhi Zakaryan, Licensees		TIME COMPLETED:	11:50 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	ANNUAL INSPECTION CONDUCTED IN ARMENIAN Licensing Program Analyst (LPA) Anomeh Eivazian conducted an unannounced annual inspection to the above facility on 01/31/22/2022. LPA arrived at the facility at 9:00 AM and met with Armen Khachyan and Varduhi Zakaryan, Licensees who guided analyst on a tour of the facility. Also present during this inspection, was Hermine Khachatryan, Licensee’s Assistant. Per licensee, Armen Khachyan facility hours are Monday to Friday from 6:30 a.m. to 6:30 p.m. This is a one story home which consists of 3 bedrooms, 2 restrooms, living room #1, living room #2, kitchen, detached converted garage which consists of a laundry room and guest house, backyard (fenced), and front yard. LPA observed three locks and a door alarm on the main entrance door. Parents enter the facility through the main entrance door which leads to living room#1. Per licensees at 9:30 a.m. the children use the living room #1, kitchen, living room #2, one bathroom in he hallway, one middle bedroom, and front part of backyard (fenced). Per licensee areas off limits to children and parents include: 2 bedrooms, one bathroom in the master bedroom, detected converted garage, front yard, back of backyard. 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 9:10 a.m., Licensee, Armen Khachyan took this LPA on a tour of the home. LPA was toured through the interior starting with the living room#1 and LPA observed sofas, a coffee table, and a TV in the living room#1. LPA observed a children's table, chairs, and toys in the living room#1. Next LPA toured the kitchen and observed child proof safety latches on the cabinets where licensees store sharp items and cleaning compounds. Next LPA toured the living room #2 adjacent to the backyard, and observed children's tables, toys, chairs in living room #2. LPA observed all electrical outlets were covered in living room#1 and living room#2. REPORT CONTINUES ON NEXT PAGE 1 of 4

SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Anomeh Eivazian
LICENSING EVALUATOR SIGNATURE:	DATE: 01/31/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/31/2022

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: ZAKARYAN & KHACHYAN FAMILY CHILD CARE	FACILITY NUMBER: 198019656
	VISIT DATE: 01/31/2022

NARRATIVE

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Next LPA toured the middle bedrooms and observed children's napping cots and one back n' play in the bedroom. Next LPA toured the bathroom in the hallway of bedrooms and observed child proof safety latches on the cabinets where licensees store cleaning compounds. Next LPA toured the two off-limit bedrooms and one bathroom in the master bedroom and did not observe any hazards. LPA observed plastic door knobs on off-limit areas door knobs. LPA observed licensees family members personal belongings in the home. LPA observed the required 2A 10BC fire extinguisher was anchored to the wall in the kitchen. It was serviced on 01/10/2022 as read by LPA from the service tag. Licensee tested the carbon monoxide detector in the kitchen and smoke detector in the living room #2. 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. The restroom that children use was observed to be safe and sanitary.

Next LPA toured the backyard fenced. Currently, children are using the front part of back yard (fenced) 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. LPA observed a sliding gate was installed to the stairs in the backyard. LPA observed off-limit areas in the backyard was separated by gate. The licensee states that supervision is always provided.

Per Licensee, Armen Khachyan at 10:13 a.m there are no pets, weapons, firearms, pools, spas, hot tubs, fish ponds, or similar bodies of water on the premises.

The licensees were observed to be operating within the licensed capacity and is not exceeding the required limitations during this inspection. During this inspection LPA observed 7 children with licensees and one assistant. All adults present have obtained a criminal record clearance on Licensing Information System (LIS). Per licensee, Armen Khachyan at 10:20 a.m. currently they have one assistant. Licensees were 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.

REPORT CONTINUES ON NEXT PAGE 2 of 4

SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Anomeh Eivazian
LICENSING EVALUATOR SIGNATURE:	DATE: 01/31/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/31/2022

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: ZAKARYAN & KHACHYAN FAMILY CHILD CARE	FACILITY NUMBER: 198019656
	VISIT DATE: 01/31/2022

NARRATIVE

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The licensees, Varduhi Zakaryan and Armen Khachyan have completed training on preventive health practices including Pediatric First Aid and CPR. The licensees' and and Hermine Khachatryan, assistant Pediatric First Aid and CPR expires on 01/2024. Licensee, Armen Khachyan completed required mandated reporter training on 01/31/2022. Licensee, Varduhi Zakaryan and Hermine Khachatryan, assistant are exempt from mandated reporter training due to language barrier. 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 10:30 a.m., facility roster was reviewed and completed. Per licensee, Armen Khachyan currently there are 10 children enrolled. LPA reviewed 10 children's records, including emergency information from 10 enrolled children, and all 10 reviewed files were completed. The licensees 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 12/15/2021.

Emergency Disaster Plan, Parent’s Rights Poster and the Facility License were observed to be posted at the wall by the entrance. 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 stays at the facility during operation hours.
Per licensee, they carry liability insurance in accordance with standard established by Family Child Care statue.
INFANT CARE: Licensee, Armen Khachayan states that they are caring for infants. Licensee states that infants sleep in the daycare bedroom. Appropriate sleeping arrangements and cribs were observed. (one crib for each infant in care was observed). Cribs or play yard did not hinder the entrance or exit from the sleeping space in the bedroom, mattresses shall be firm and covered with a fitted sheet that overlaps the underside so it cannot be dislodged. Cribs and play yards were observed to be free of loose articles and objects. No objects were observed to be hanging above or attached to the side of the crib. LPA did not observe any infants swaddled while in care. 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. LPA provided the licensee with a copy of A Child Care Provider’s Guide to Safe Sleep, by American Academy of Pediatrics. LPA also consulted and explained Child Abuse Reporting, Never Shake a Baby, and Safe Sleeping practices.

REPORT CONTINUES ON NEXT PAGE 3 of 4

SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Anomeh Eivazian
LICENSING EVALUATOR SIGNATURE:	DATE: 01/31/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/31/2022

LIC809 (FAS) - (06/04)

Page: 3 of 4

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: ZAKARYAN & KHACHYAN FAMILY CHILD CARE	FACILITY NUMBER: 198019656
	VISIT DATE: 01/31/2022

NARRATIVE

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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.
LPA inquired into the licensee’s practices related to COVID-19. Licensee stated that they practice hygiene such as hand washing with the children. Licensee has hand sanitizer available in the drop off area and inside her home. Licensee states they practice social distancing with children, take children temperature daily, licensee, children, and staff wear masks all the times indoor and teaching children about wearing proper face covering.
At this time, the licensee is in compliance with California Title 22 Regulations. Therefore, there are no citations being issued today from the areas that were inspected today.
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, Armen Khacyan at 11:50 a.m..

REPORT END 4 of 4

SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Anomeh Eivazian
LICENSING EVALUATOR SIGNATURE:	DATE: 01/31/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/31/2022

LIC809 (FAS) - (06/04)

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