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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198020225
Report Date: 03/03/2023
Date Signed: 03/03/2023 11:18:51 AM

Document Has Been Signed on 03/03/2023 11:18 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:GRIGORYAN FAMILY CHILD CAREFACILITY NUMBER:
198020225
ADMINISTRATOR:GAYANE GRIGORYANFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(818) 653-9295
CITY:GLENDALESTATE: CAZIP CODE:
91201
CAPACITY: 14TOTAL ENROLLED CHILDREN: 13CENSUS: 10DATE:
03/03/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Gayane Grigoryan, LicenseeTIME COMPLETED:
11:40 AM
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CASE- MANAGEMENT INSPECTION CONDUCTED IN ARMENIAN
Licensing Program Analyst (LPA) Anomeh Eivazian conducted an unannounced case- management inspection to the above facility on 03/03/2023 to verify Vagharshak Grigoryan, Licensee's son does not reside at this address. LPA arrived at the facility at 9:00 AM and met with Gayane Grigoryan, Licensee who guided analyst on a tour of the facility. Also present during this inspection, were Araksyan Gasparyan and Ani Stepanyan, licensee's assistants, Vahe Grigoryan, licensee's son, Armen Grigoryan, licensee's husband, and Anhit Grigoryan and Aram Grigoryan, licensee's in-laws . Per licensee, Gayane Grigoryan facility hours are Monday to Friday from 7:00 a.m. to 11:00 p.m..

This is a one story home located on the first level which consists of 2 bedrooms, 2 full and 2 half bathrooms, Kids play room, Kids bedroom, kitchen, dining room, living room (FIREPLACE: inaccessible), front yard, backyard (fenced), detached storage in the backyard. Per licensee at 9:10 a.m. the children use the Kids playroom, kids bedroom, half bathroom in Kids playroom, and daycare outdoor activity area in the backyard. Per licensee, parents enter the facility through the side gate which leads to the backyard and daycare rooms or through the main entrance door which leads to the living room. Per licensee areas off limits to children and parents include: 2 bedrooms, living room, dining room, kitchen, two full and one half bathrooms, front yard, off-limit area in the backyard and detached storage in the 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 were inspected for safety, comfort, and cleanliness. At 9:10 a.m., Licensee took this LPA on a tour of the home. LPA was toured through the interior starting with Kids playroom.Upon LPA's arrival LPA observed 8 children with licensee and her assistants in Kids Playroom. During this inspection two children were dropped off and total of 10 children were present in the home. LPA observed children tables, chairs, and toys in the Kids Play room. Next LPA toured the Kids Bedroom and observed 4 pack n'play and napping cots in the Kids Bedroom. Next LPA toured the half daycare bathroom in
REPORT CONTINUES ON NEXT PAGE 1 of 4
SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Anomeh Eivazian
LICENSING EVALUATOR SIGNATURE: DATE: 03/03/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/03/2023
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: GRIGORYAN FAMILY CHILD CARE
FACILITY NUMBER: 198020225
VISIT DATE: 03/03/2023
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Kids Playroom and did not observe any hazards. LPA observed all electrical outlets were covered in daycare area. Next LPA toured the off-limit living room, dining room, kitchen, two bedrooms, two and 1/2 bathroom, detached storage in the backyard and did not observe any hazards.

Per licensee, currently there is a construction in the backyard and she has not taken the children outside since 02/01/2023. Per licensee, once she decides to take the children outside for outdoor playarea, license will contact LPA Eivazian and pictures will be provided.

During this inspection LPA talked to 5 children and showed Licensee's son, Vagharshak Grigoryan's picture to 5 children in order to verify if they will be able to identify him or not. Only Child#1, who is a licenee's friend child was able to identity licensee's son, Vagharshak Grigoryan.

During this inspection LPA Eivazian conducted interviews with two licensee's assistants. LPA obtained a copy of facility current roster and declarations from licensee, licensee's husband and two assistants.

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.

Exit interview conducted and report was reviewed with the Licensee, Gayane Grigoryan at 11:40 a.m..

REPORT END 2 of 2
SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Anomeh Eivazian
LICENSING EVALUATOR SIGNATURE:

DATE: 03/03/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/03/2023
LIC809 (FAS) - (06/04)
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