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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198020430
Report Date: 03/14/2024
Date Signed: 03/14/2024 02:46:07 PM

Document Has Been Signed on 03/14/2024 02:46 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:SARGSYAN FAMILY CHILD CAREFACILITY NUMBER:
198020430
ADMINISTRATOR:ANNA SARGSYANFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(424) 224-1698
CITY:GLENDALESTATE: CAZIP CODE:
91202
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 7DATE:
03/14/2024
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
01:55 PM
MET WITH:Ashken Gasparyan, Licensee's AssistantTIME COMPLETED:
03:00 PM
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PLAN OF CORRECTION VISIT WAS CONDUCTED IN ARMENIAN
Licensing Program Analyst, Anomeh Eivazian conducted an unannounced Plan of Correction (POC) inspection to the above facility on 03/14/24 to ensure Type A deficiency cited on 03/04/24 has been cleared. LPA arrived at 1:55 PM and met with Ashken Gasparyan, licensee’s mother/assistant who guided analyst on a tour of the facility. During this inspection licensee, Anna Sargsyan was not present in the home. LPA talked to licensee over the phone who stated she left to do some shopping. During this inspection there were seven children present in the home. Also, Greta Evoyan, licensee’s assistant was present in the home during this inspection.

The following has been observed:

Staff ratio and capacity has been met. During this inspection, there were seven children in care with licensee’s two assistants. LPA observed on child was watching TV in the living room and six children were napping in daycare area.

Acknowledgement forms were observed for all children in care.

LPA cleared deficiency on this date and provided a copy of the Licensing Report to Ashken Gasparyan, Licensee’s assistant, and issued POC clearance letter.



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’s assistant, Ashken Gasparayn at 3:00 p.m..
SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Anomeh Eivazian
LICENSING EVALUATOR SIGNATURE: DATE: 03/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/14/2024
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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