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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198020558
Report Date: 07/12/2024
Date Signed: 07/12/2024 09:17:53 AM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
This is an official report of an unannounced visit/investigation of a complaint received in our office on
05/16/2024 and conducted by Evaluator Anomeh Eivazian
PUBLIC
COMPLAINT CONTROL NUMBER: 33-CC-20240516141133
FACILITY NAME:KOSTANYAN FAMILY CHILD CAREFACILITY NUMBER:
198020558
ADMINISTRATOR:EMMA KOSTANYANFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(818) 468-9418
CITY:GLENDALESTATE: CAZIP CODE:
91206
CAPACITY:14CENSUS: 3DATE:
07/12/2024
UNANNOUNCEDTIME BEGAN:
07:25 AM
MET WITH:Emma Kostanyan, LicenseeTIME COMPLETED:
09:30 AM
ALLEGATION(S):
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Licensee operates out of ratio
Licensee use detached converted garage as day-care area
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Anomeh Eivazian conducted an unannounced complaint inspection to the above facility for the purpose of delivering the complaint findings. LPA arrived at 7:25 a.m. on 07/12/24 and met with Emma Kostanyan, licensee who guided analyst on a tour of the facility. During this inspection there were 3 children present in the facility. Also during this inspection licensee’s husband, Vilik Kostanyan was present in the home. During this inspecton licensee's assistants, Nora Sergoyan and Siran Grigoryan arrived to the facility.

During this investigation, LPA Eivazian conducted interviews with three staff and two random parents. LPA obtained a copy of facility current roster.

Based on an interview that was conducted with staff#1 on 05/20/24, currently there are 13-14 children enrolled in the daycare, two being school age. Per licensee, there were two occasions during past couple months, can not recall the exact date, that there were more 14 children present in the facility. Once there
REPORT CONTINUES ON NEXT PAGE 1 of 2
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Anomeh Eivazian
LICENSING EVALUATOR SIGNATURE:

DATE: 07/12/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/12/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 5
Control Number 33-CC-20240516141133
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION 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: KOSTANYAN FAMILY CHILD CARE
FACILITY NUMBER: 198020558
VISIT DATE: 07/12/2024
NARRATIVE
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were 15 and once there were 16 children present in the facility. Per licensee, detached converted garage is off-limit area, however children were present in the detached converted garage couple times for short period of time to do art and playing with play dough. Also, early May 2024, twice children slept in the detached converted garage (off-limit area).

Based on an interview that was conducted with staff#3 on 05/20/24, during last 10 days children slept and played in the detached converted garage.

Based on LPA's observations and interviews which were conducted and record reviews, the preponderance of evidence standard has been meet, therefore the above allegations are found to be Substantiated at this time. Title 22 Regulation Code 102371 (a)-- Fire Safety Clearance-- A fire safety clearance approved by the city or county fire department, the district providing fire protection services, or the State Fire Marshal shall be required for a large family child care home and 102416.5 (a)--Staffing Ratio and Capacity-- The capacity specified on the license shall be the maximum number of children for whom care may be provided at any one time are being cited on the attached LIC9099D.

LPA Eivazian informed licensee, Emma Kostanyan that this report dated 07/12/24 document(s) two Type A citations. Type A citation(s) which shall be posted for 30 consecutive days as there is/are immediate risk(s) to the health, safety, or personal rights of children in care.

Also, LPA Eivazian informed the licensee, Emma Kostanyan to provide a copy of this licensing report dated 07/12/24 that documents any Type A citation(s) to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

A notice of site visit 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, Emma Kostanyan.
REPORT END 2 of 2
SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Anomeh Eivazian
LICENSING EVALUATOR SIGNATURE:

DATE: 07/12/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/12/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 5
Control Number 33-CC-20240516141133
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION 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: KOSTANYAN FAMILY CHILD CARE
FACILITY NUMBER: 198020558
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/12/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
07/15/2024
Section Cited
CCR
102416.5(a)
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102416.5 (a)--Staffing Ratio and Capacity-- The capacity specified on the license shall be the maximum number of children for whom care may be provided at any one time.
This requirement was not met as evidenced by….
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Per licensee, currently she has 12 children enrolled and effective today she will operates according to Title 22 Regulations staffing and capacity requirements.

A written declaration will be submitted to LPA by 07/15/24.
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Per staff#1 interview on 05/20/24, there were two occasions that once licensee had 15 and once, she had 16 children present in the facility and licensee violated staffing ratio and capacity requirements.
This poses an immediate health, safety and personal right risk to the children in care.
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Type A
07/15/2024
Section Cited
CCR
102371(a)
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102371(a)-- Fire Safety Clearance-- A fire safety clearance approved by the city or county fire department, the district providing fire protection services, or the State Fire Marshal shall be required for a large family child care home.
This requirement was not met as evidenced by...
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Per licensee, effective today she will not use the detached converted garage as dayare area.
A written declaration will be submitted to LPA by 07/15/24.
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Based on staff#1 and staff#3 interviews on 05/20/24, children played and slept in the detached converted garage (off-limit area). There is no fire clearance on file for the use of the garage for the day-care children to use for play or sleep.
This poses an immediate health, safety, and personal right risk to the children in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Anomeh Eivazian
LICENSING EVALUATOR SIGNATURE:

DATE: 07/12/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/12/2024
LIC9099 (FAS) - (06/04)
Page: 3 of 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
This is an official report of an unannounced visit/investigation of a complaint received in our office on
05/16/2024 and conducted by Evaluator Anomeh Eivazian
PUBLIC
COMPLAINT CONTROL NUMBER: 33-CC-20240516141133

FACILITY NAME:KOSTANYAN FAMILY CHILD CAREFACILITY NUMBER:
198020558
ADMINISTRATOR:EMMA KOSTANYANFACILITY TYPE:
810
ADDRESS:400 N. JACKSON ST.TELEPHONE:
(818) 468-9418
CITY:GLENDALESTATE: CAZIP CODE:
91206
CAPACITY:12CENSUS: 3DATE:
07/12/2024
UNANNOUNCEDTIME BEGAN:
07:25 AM
MET WITH:Emma Kostanyan, LicenseeTIME COMPLETED:
09:30 AM
ALLEGATION(S):
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Licensee does not live in the facility address
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Anomeh Eivazian conducted an unannounced complaint inspection to the above facility for the purpose of delivering the complaint finding. LPA arrived at 7:25 a.m. on 07/12/24 and met with Emma Kostanyan who guided analyst on a tour of the facility. During this inspection there were 3 children present in the facility. Also during this inspection licensee’s husband, Vilik Kostanyan was present in the home. During this inspecton licensee's assistants, Nora Sergoyan and Siran Grigoryan arrived to the facility.

LPA Eivazian conducted interviews with three staff and two random parents. LPA obtained a copy of facility current roster.

Based on an interview that was conducted with staff#1, she lives at this address with her family and she does not have another resident. A written declaration obtained on this date.

REPORT CONTINUES ON NEXT PAGE 1 of 2
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Anomeh Eivazian
LICENSING EVALUATOR SIGNATURE:

DATE: 07/12/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/12/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 33-CC-20240516141133
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION 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: KOSTANYAN FAMILY CHILD CARE
FACILITY NUMBER: 198020558
VISIT DATE: 07/12/2024
NARRATIVE
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Based on interviews that were conducted with two random parents, they are in impression that licensee lives at this address.

Based on LPA's observation on 05/20/24 and 07/12/24, LPA observed licensee's family members personal belongings in the home in the second floor. On 07/12/24, LPA arrived at the facility at 7:25 a.m., and met with licensee and her husband.

The allegation may have happened or is valid, but there is not a preponderance of evidence to prove the alleged violation occurred, therefore the allegation is unsubstantiated at this time. The evidence scale is equal meaning the weight of convincing evidence to prove something happened is equal to and has just as much convincing weight that it did not happen.

The Notice of Site Visit (LIC 9213) was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the Emma Kostanyan.

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

DATE: 07/12/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/12/2024
LIC9099 (FAS) - (06/04)
Page: 5 of 5