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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198019987
Report Date: 10/26/2023
Date Signed: 10/26/2023 10:24:47 AM

Document Has Been Signed on 10/26/2023 10:24 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
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:SEROBYAN FAMILY CHILD CAREFACILITY NUMBER:
198019987
ADMINISTRATOR:LILIT SEROBYANFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(626) 818-1109
CITY:PASADENASTATE: CAZIP CODE:
91107
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 0DATE:
10/26/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Lilit Serobyan - LicenseeTIME COMPLETED:
10:42 AM
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Licensing Program Analyst (LPA) Nolan Tcheng conducted an unannounced Case Management-Other inspection, for the purpose of removing facility from inactive status. Upon arrival at 8:30am, LPA met with Licensee Lilit Serobyan, to whom the purpose of the inspection was explained. Licensee states they currently have 0 children enrolled. Licensee's hours of operation are 7:30am-5:30pm, Monday-Friday.

This is a one-story home which consists of 4 bedrooms, 3 bathrooms, two kitchens, front room, living room (child care area), front yard, side yard, and detached Additional Dwelling Unit (ADU). The children use two bedrooms (nap), back living room, bathroom attached to living room, and front yard. Per licensee, areas off limits to children and parents include: front room, three bedrooms, 2 bathrooms, both kitchens, side yard, back yard, and ADU. All areas identified on the facility sketch were inspected. The licensee will provide food for children in care.

The licensee states that 3 adults and 3 minors currently live in the home. Persons living in the home are identified on the attached LIC811. All individuals present in the home have obtained a criminal record clearance or exemption prior to working, residing or volunteering in a licensed home. Per licensee, there are no bodies of water on the premises. Licensee states there is a firearm present at the home, safely stored per Title 22 regulations. Please see attached LIC812 for additional information.

At 8:45am, LPA was led on a tour of the facility by licensee. LPA observed all the off limit areas of the home. Rooms that are not for child care have child safety covers on the doorhandles to help prevent access from children. LPA observed the two bedrooms that would be used for children in care. One has a bed and space for an older child. Per licensee, the bedroom will be used as an area for an ill child until an authorized representative comes to pick up child. The bedroom adjacent to it has a changing table and two cribs for infant children. The tour continued to the back living room room area. Per licensee, during their inactive status they remodeled the back area to increase open space for children in care to use. The bathroom attached will be used for children in care. Detergents, cleaning compounds, medications, and other items which could pose a danger are inaccessible to children. REPORT CONTINUES PAGE 1 of 3

SUPERVISORS NAME: Claudia Guangorena
LICENSING EVALUATOR NAME: Nolan Tcheng
LICENSING EVALUATOR SIGNATURE: DATE: 10/26/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/26/2023
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
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: SEROBYAN FAMILY CHILD CARE
FACILITY NUMBER: 198019987
VISIT DATE: 10/26/2023
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The kitchen present was pre-existing and added an island to separate from child activity space, and has safety gates to prevent children from entering. Emergency Disaster Plan, Parent’s Rights Poster and the Facility License are observed to be posted in the back living room. There is a side door that Licensee states will serve as the parent pick up and drop off. There are age appropriate toys and equipment for children in care to use. At 9am, a fire extinguisher was observed. The valve on the required 2A 10BC fire extinguisher indicates fully charged and was purchased on 10/24/2023, as indicated on receipt. Per State Fire Marshall standards, fire extinguishers shall be serviced annually. Smoke and carbon monoxide detectors were tested and are operable. The licensee states that there is a land line on the premises. LPA observed napping equipment in the form of cots. Equipment is stored in child care living room. LPA obtained updated facility sketch during inspection.

At 9:15am, LPA observed the front yard area. The outdoor play area was observed to be fenced. At this time, children are using the front yard for outdoor play time. There is age appropriate equipment for children in care to use. The licensee is observed to be operating within the license capacity limitations.

The licensee has not completed training on preventive health practices including Pediatric First Aid and CPR. LPA observed the Pediatric CPR/FIrst Aid was online only. LPA provided www.emsa.ca.gov website to licensee and instructed them to register and take a course that includes in-person/hands on portion.Licensee has not renewed their Mandated Reporter Child Care Proivder Training and will need to complete the training prior to care. The licensee does have proof of immunization against influenza, tuberculosis, pertussis, and measles. LPA discussed the requirements for children's record's.

The following was discussed:


-There are no pets on the premises.
-Infant Walkers, Johnny Jumpers, Saucer Chairs, and/or any other item that falls into these categories are not permitted in a family child care facility.
-Smoking is prohibited in a license family child care home.

Licensee 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 REPORT CONTINUES PAGE 2 of 3

SUPERVISORS NAME: Claudia Guangorena
LICENSING EVALUATOR NAME: Nolan Tcheng
LICENSING EVALUATOR SIGNATURE:

DATE: 10/26/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/26/2023
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
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: SEROBYAN FAMILY CHILD CARE
FACILITY NUMBER: 198019987
VISIT DATE: 10/26/2023
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LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep as an additional resource. LPA also informed licensee [or facility 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.

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 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 Licensee confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

The following corrections need to be corrected prior to being removed from Inactive Status. Corrections are due by 11/09/2023:

  1. Licensee will complete EMSA approved Pediatric First Aid/CPR
  2. Licensee will complete Mandated Reporter Child Care Provider (AB1207) Training
  3. Licensee will purchase a first aid kit

Upon receipt of these corrections, and pending final review, License will be removed from Inactive Status.

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

Exit interview conducted and report was reviewed with the licensee Lilit Serobyan, at 10:15am. Copy of report provided.

END OF REPORT PAGE 3 of 3

SUPERVISORS NAME: Claudia Guangorena
LICENSING EVALUATOR NAME: Nolan Tcheng
LICENSING EVALUATOR SIGNATURE:

DATE: 10/26/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/26/2023
LIC809 (FAS) - (06/04)
Page: 3 of 3