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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198020457
Report Date: 01/03/2022
Date Signed: 01/03/2022 11:24:28 AM

Document Has Been Signed on 01/03/2022 11:24 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
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:GHAZARYAN FAMILY CHILD CAREFACILITY NUMBER:
198020457
ADMINISTRATOR:SHUSHANIK GHAZARYANFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(248) 469-2959
CITY:GLENDALESTATE: CAZIP CODE:
91203
CAPACITY: 14TOTAL ENROLLED CHILDREN: 11CENSUS: 7DATE:
01/03/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:50 AM
MET WITH:Shushanik Ghazaryan, licenseeTIME COMPLETED:
11:40 AM
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ANNUAL INSPECTION CONDUCTED IN ARMENIAN
Licensing Program Analyst (LPA) Anomeh Eivazian conducted an unannounced annual inspection to the above facility on 01/03/2022. LPA arrived at the facility at 8:50 AM and met with Shushanik Ghazaryan, Licensee who guided analyst on a tour of the facility. Also present during this inspection, were Sargis Kishmishyan, licensee's husband and Marina Lalayan, Licensee’s Assistant. Per licensee, shushanik Ghazaryan facility hours are Monday to Friday from 7:30 a.m. to 5:30 p.m.

This is a one story home located on the first level. The home consists of 3 bedrooms, 2 restrooms, living room, kitchen, laundry room, front yard, backyard (fenced) and garage. Per licensee at 9: 20 a.m. the children use the bathroom in the hallway, living room (day care area), kitchen and front part of backyard (fenced).Per licensee, parents enter the facility through the main entrance which leads to the living room. Per licensee areas off limits to children and parents include: Three bedrooms, 1 bathroom in the master bedroom, front yard, back of backyard, and garage. LPA did not observe stairs in the home. 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 took this LPA on a tour of the home. LPA was toured through the interior starting with the living room. LPA observed electric outlets were covered in the living room, LPA observed children toys, chairs and tables in the living room. Posting requirements were observed to be posted in the living by the entrance door in the living room. Licensee showed LPA the fire extinguisher was purchased on 01/03/2021 as read by LPA from the receipt. LPA observed Fire Extinguisher was placed on the cabinet in the living room by the main entrance. Next LPA was toured through the kitchen where LPA observed a dining table and chairs. LPA observed safety latches on the cabinets in the kitchen where licensee stores cleaning compounds and sharp items.
REPORT CONTINUES ON NEXT PAGE 1 of 5
SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Anomeh Eivazian
LICENSING EVALUATOR SIGNATURE: DATE: 01/03/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/03/2022
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: GHAZARYAN FAMILY CHILD CARE
FACILITY NUMBER: 198020457
VISIT DATE: 01/03/2022
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 LPA observed a safety gate by the kitchen to make the kitchen inaccessible to the children. Per licensee, children only transpass from kitchen to go to the backyard. Next LPA toured the bathroom in the hallway and did not observe any hazards. Next LPA toured 3 off-limit bedrooms and off-limit bathroom in the master bedroom and did not observe any hazards. LPA observed licensee's family members personal belongings in off-limit bedrooms. LPA observed a safety gate was installed in the hallway of bedrooms to make 2 off limit bedrooms inaccessible to the children. Licensee tested the carbon monoxide and smoke detectors in the hallway of the bedrooms. 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.

Next LPA toured the backyard fenced. Currently, children are using the front part of back yard 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 children play house, swing and play structure in the backyard and entire ground was covered with artificial grass. The licensee states that supervision is always provided. Areas off limit in the backyard are gates to be inaccessible to the children.

Per Licensee, Shushanik Ghazaryan at 9:45 a.m there are no pets, weapons, firearms, pools, spas, hot tubs, fish ponds, or similar bodies of water on the premises. LPA observed an aquarium in the living room.

The licensee was observed to be operating within the licensed capacity and is not exceeding the required limitations during this inspection. During this inspection LPA observed seven children in the living room with licensee and her assistant. All adults present have obtained a criminal record clearance on Licensing Information System (LIS). Per licensee, currently she has one assistant. Licensee was 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 5
SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Anomeh Eivazian
LICENSING EVALUATOR SIGNATURE:

DATE: 01/03/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/03/2022
LIC809 (FAS) - (06/04)
Page: 2 of 5
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: GHAZARYAN FAMILY CHILD CARE
FACILITY NUMBER: 198020457
VISIT DATE: 01/03/2022
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The licensee and other personnel have completed training on preventive health practices including Pediatric First Aid and CPR. The licensee's and her assistant, Marina Lalayan Pediatric First Aid and CPR expires on 10/2023. Licensee, Shushanik Ghazaryan is exempt from required mandated reporter training due to language barrier. There are first aid supplies available on the premises in the living room. LPA advised licensee that if a child shows signs of illness he/she/they shall be separated from other children.

At 10:00 a.m., facility roster was reviewed and completed. Per licensee currently there are 11 children enrolled. LPA reviewed 11 children's records, including emergency information from 11 enrolled children, and all 11 reviewed files were completed. The licensee does 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 10/21/2021. 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 cellphone that is used and the cellphone stays at the facility during operation hours. Per licensee she does not carry liability insurance or a bond in accordance with standard established by Family Child Care statue. Signed statements (LIC282) on 11 reviewed files.

SAFE SLEEP: LPA discussed the safe sleep regulations with licensee, Shushanik Ghazaryan 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
REPORT CONTINUES ON NEXT PAGE 3 of 5
SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Anomeh Eivazian
LICENSING EVALUATOR SIGNATURE:

DATE: 01/03/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/03/2022
LIC809 (FAS) - (06/04)
Page: 3 of 5
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: GHAZARYAN FAMILY CHILD CARE
FACILITY NUMBER: 198020457
VISIT DATE: 01/03/2022
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INFANT CARE: Licensee states that she does not provide care to infants. Licensee states that infants will sleep in the living room (daycare area) where they are constantly supervised. Appropriate sleeping arrangements and cribs will be available . (one crib for each infant in care is required). Cribs or play yard shall not hinder the entrance or exit from the sleeping space , mattresses shall be firm and covered with a fitted sheet that overlaps the underside so it cannot be dislodged. Cribs and play yards shall be free of loose articles and objects. No objects shall 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.

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 also discussed the Provider Information Notices (PINS) on Safe Sleep Awareness: PIN 19-02-CCP,
U.S. CONSUMER PRODUCT SAFETY COMMISSION FISHER-PRICE INFANT EQUIPMENT RECALLS: PIN 20-19 CCP COVID FAQ - PIN 20-11-CCP, Required Lead Testing: PIN 20-01 CCP Effects of Lead Exposure, and Guardian User Account Access - PIN 20-20-CCLD.
REPORT CONTINUES ON NEXT PAGE 4 of 5
SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Anomeh Eivazian
LICENSING EVALUATOR SIGNATURE:

DATE: 01/03/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/03/2022
LIC809 (FAS) - (06/04)
Page: 4 of 5
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: GHAZARYAN FAMILY CHILD CARE
FACILITY NUMBER: 198020457
VISIT DATE: 01/03/2022
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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 and staff wear masks all the times indoor and teaching children about wearing proper face covering. During this inspection LPA issued a Technical Advisory to licensee to ensure children above 2 years old, staff and parents wear masks all the times while indoor.

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, Shushanik Ghazaryan at 11:40.m..
REPORT END 5 of 5
SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Anomeh Eivazian
LICENSING EVALUATOR SIGNATURE:

DATE: 01/03/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/03/2022
LIC809 (FAS) - (06/04)
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