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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198020587
Report Date: 07/08/2026
Date Signed: 07/08/2026 03:55:01 PM

Document Has Been Signed on 07/08/2026 03:55 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:GIESOGIAN FAMILY CHILD CAREFACILITY NUMBER:
198020587
ADMINISTRATOR/
DIRECTOR:		NAZIK GIESOGIANFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(626) 993-8989
CITY:PASADENASTATE: CAZIP CODE:
91104
CAPACITY: 14TOTAL ENROLLED CHILDREN: 15CENSUS: 13DATE:
07/08/2026
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:00 PM
MET WITH:Nazik Giesogian, LicenseeTIME VISIT/
INSPECTION COMPLETED:
04:10 PM
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ANNUAL INSPECTION CONDUCTED IN ARMENIAN
On 07/08/26, at 1:00 PM, Licensing Program Analyst (LPA) Anomeh Eivazian conducted an unannounced annual/random inspection to the above facility. LPA met with Nazik Giesogian, Licensee who guided analyst on a tour of the facility. Also present during this inspection, was Vatse Baltagian, Licensee’s Assistant/husband, Azniv Harutyunyan and Varduhi Sahakyan, Licensee’s Assistants. LPA provided a copy of Entrance Checklist—Family Child Care Home (LIC126) to licensee. Per licensee, facility hours are Monday to Sunday from 7:00 a.m. to 10:00 p.m.. Per licensee she provides care to children 18 months old to 13 years old.

This is a one-story home located on the first level. The home consists of 3 bedrooms, 2 bathrooms, kitchen, dining room, living room, basement, garage (storage area) , front yard and backyard (fenced). Per licensee, parents enter the facility through the main entrance which leads to the living room or side gate which leads to the backyard.

Per licensee the children use the living room (daycare area), dining room, 1 bathroom in the hallway of bedrooms, kitchen, and backyard (fenced). Per licensee areas off limits to children and parents include: 3 bedrooms, one bathroom, basement, back of backyard, front yard and garage (storage area) . During this inspection individuals who reside in the home were discussed and notes on Confidential Name List (LIC811) and attached to this report. LPA did not observe any stairs in the home.

All areas identified on the facility sketch that are accessible for children to use were inspected for safety, comfort, and cleanliness. At 1:05 p.m., Licensee took this LPA on a tour of the home. LPA was toured through the interior starting with the living room (daycare classrooms), LPA observed children's table, chairs,

REPORT CONTINUES ON NEXT PAGE 1 of 5
NAME OF LICENSING PROGRAM MANAGER: Christina Gabelman
NAME OF LICENSING PROGRAM ANALYST: Anomeh Eivazian
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 07/08/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/08/2026
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 8
California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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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: GIESOGIAN FAMILY CHILD CARE
FACILITY NUMBER: 198020587
VISIT DATE: 07/08/2026
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and toys in the living room. LPA observed all electrical outlets were covered in living room. There is a fireplace in the living room which has been blocked off to prevent access. LPA observed 13 children, three being school age, were napping in the living room with licensee and her two assistants. Next LPA toured the dining room and observed two sofas, a dining table, and chairs in the dining room. Next LPA toured the kitchen and observed child proof safety latches on the cabinets where licensee stores sharp items and cleaning compounds. Per licensee children only talk through the kitchen to go to the backyard. There is a door in the kitchen which leads to the basement and LPA observed the basement door was closed and locked during this inspection. LPA observed a safety gate was installed to the kitchen one entrance and per licensee she keeps the kitchen door closed all the time. Next LPA toured the daycare bathroom and observed child proof safety latches on the cabinet under the sink where licensee stores cleaning compounds. LPA observed a safety gate was installed in the hallway of off-limit bedrooms to make the off-limit areas inaccessible to the children. Next LPA toured the off-limit three bedrooms and one off-limit bathroom and did not observe any hazards. LPA observed licensee's and her family members personal belongings in the home. LPA observed the required 2A 10BC fire extinguisher was anchored to the wall in the kitchen. It was serviced on 07/26/24 as read by LPA from the receipt and it was not serviced annually as is required. Licensee tested the carbon monoxide detector in the hallway of bedrooms and smoke detector in the living room. 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. LPA observed that the outdoor yard has toys and other materials for children to play with. Per licensee children walk through the dining room and kitchen to go to the backyard. LPA observed off-limit area of backyard was separated by safety gate to be inaccessible to the children. LPA observed the outdoor playarea ground is cement and artificial grass. LPA did not observe any objects that can pose a danger to children in the outdoor yard. The licensee states that supervision is always provided. Next LPA toured the off-limit garage (storage area) and did observe any hazards. Per licensee the garage door is kept closed all the time.

Per licensee, she provides food for children in care. Licensee was advised that if food is brought from the children’s homes, all containers must be labeled with child’s name and properly stored or refrigerated. Per Licensee, Nazik Giesogian at 2:10 p.m there are no pets, weapons, firearms, pools, spas, hot tubs, fish ponds, or similar bodies of water on the premises.

REPORT CONTINUES ON NEXT PAGE 2 of 5
NAME OF LICENSING PROGRAM MANAGER: Christina Gabelman
NAME OF LICENSING PROGRAM ANALYST: Anomeh Eivazian
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 07/08/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/08/2026
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: GIESOGIAN FAMILY CHILD CARE
FACILITY NUMBER: 198020587
VISIT DATE: 07/08/2026
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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 13 children, three being school age were napping in the living room with licensee and her two assistants. All adults present have obtained a criminal record clearance on Licensing Information System (LIS). Per licensee, currently she has two assistants. 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.

The licensee and other personnel have completed training on preventive health practices including Pediatric First Aid and CPR. The licensee's Pediatric First Aid and CPR expires on 02/2028. Licensee, Nazik Giesogian completed required mandated reporter training on 01/25/26. There are first aid supplies available on the premises in the living room in the closet. LPA advised licensee that if a child shows signs of illness he/she/they shall be separated from other children.



At 2:00 p.m., facility roster was reviewed and completed. Per licensee currently there are 15 children enrolled. LPA reviewed 6 children's records, including emergency information from 15 enrolled children, and all 6 reviewed files were completed.

The licensee and her assistant, Azniv Harutyunyan have proof of immunization against influenza, pertussis, and measles. Licensee’s assistant, Varduhi Sahakyan, did not have proof of immunization against pertussis and Influenza and TB test clearance on file.

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 05/20/26. Emergency Disaster Plan, Parent’s Rights Poster and the Facility License were observed to be posted at the wall by the entrance in the living room.

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.
REPORT CONTINUES ON NEXT PAGE 3 of 5
NAME OF LICENSING PROGRAM MANAGER: Christina Gabelman
NAME OF LICENSING PROGRAM ANALYST: Anomeh Eivazian
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 07/08/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/08/2026
LIC809 (FAS) - (06/04)
Page: 4 of 8
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: GIESOGIAN FAMILY CHILD CARE
FACILITY NUMBER: 198020587
VISIT DATE: 07/08/2026
NARRATIVE
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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 6 reviewed files. Per licensee, she does not provide transportation.

Licensee RENTS/LEASES THE HOME: The licensee provided proof of control of property. Licensee rents the home and has landlord consent form on file. Licensee confirmed that LIC 9149 was signed by landlord.

INFANT CARE: Per licensee, she provides care to infants (18-24 months old). Licensee states that if an infant is enrolled, the infant will sleep in the living room and dining room where they are constantly supervised. 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 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-and-resources/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 https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.


Medication: Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 2202-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) 5140383 (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/. LPA advised the licensee to access forms, regulations and quarterly updates online at: www.ccld.ca.gov.
REPORT CONTINUES ON NEXT PAGE 4 of 5
NAME OF LICENSING PROGRAM MANAGER: Christina Gabelman
NAME OF LICENSING PROGRAM ANALYST: Anomeh Eivazian
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 07/08/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/08/2026
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: GIESOGIAN FAMILY CHILD CARE
FACILITY NUMBER: 198020587
VISIT DATE: 07/08/2026
NARRATIVE
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The following deficiencies listed on the attached LIC 809 (deficiency page) are being cited in accordance with California Code of Regulations Title 22. Deficiencies that are being cited need to be cleared to protect the children’s health & safety.

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

To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

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

Exit interview conducted and report was reviewed with the licensee, Nazik Giesogian.
REPORT END 5 of 5
NAME OF LICENSING PROGRAM MANAGER: Christina Gabelman
NAME OF LICENSING PROGRAM ANALYST: Anomeh Eivazian
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 07/08/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/08/2026
LIC809 (FAS) - (06/04)
Page: 6 of 8
Document Has Been Signed on 07/08/2026 03:55 PM - It Cannot Be Edited


Created By: Anomeh Eivazian On 07/08/2026 at 01:48 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: GIESOGIAN FAMILY CHILD CARE
FACILITY NUMBER: 198020587

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/08/2026

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102417(g)(1)
Operation of A Family Child Care Home
(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (1) Fireplaces and open face heaters shall be screened to prevent access by children. The home shall contain a fire extinguisher and smoke detector device which meet standards established by the State Fire Marshall.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on LPA's observations the licensee did not comply with the section cited above and fire extinguisher was not serviced annually as it is required which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 08/07/2026
Plan of Correction
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Per licensee, she will buy a new fire extinguisher by 08/07/26.
Type B
Section Cited
HSC
1597.622(a)(1)
General Provisions and Definitions
(1) Commencing September 1, 2016, a person shall not be employed or volunteer at a family day care home if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on staff files review, the licensee did not comply with the section cited above in 1 out of 2 staff, Varduhi Sahakyan did not have proof of immunization against pertussis and influenza on file which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 08/07/2026
Plan of Correction
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Per licensee, her assistant, Varduhi Sahakyan will have proof of immunization against Pertussis (TDAP) and influenza by 08/07/26.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Christina Gabelman
NAME OF LICENSING PROGRAM MANAGER:
Anomeh Eivazian
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 07/08/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/08/2026


LIC809 (FAS) - (06/04)
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Document Has Been Signed on 07/08/2026 03:55 PM - It Cannot Be Edited


Created By: Anomeh Eivazian On 07/08/2026 at 01:53 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: GIESOGIAN FAMILY CHILD CARE
FACILITY NUMBER: 198020587

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/08/2026

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102369(b)(9)
Application for Initial License
Evidence of a current tuberculosis clearance, not more than one year prior to or seven days after initial presence in the home, for any adult in the home during the time that children are under care.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on LPA's observation the licensee did not comply with the section cited above in 1 out of 2 staff, Varduhi Sahakyan did not have TB Test clearance on file which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 08/07/2026
Plan of Correction
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Per licensee, her assistant, Varduhi Sahakyan will have TB test clearance on file by 08/07/26.
Section Cited
Deficient Practice Statement
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3
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POC Due Date:
Plan of Correction
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2
3
4
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Christina Gabelman
NAME OF LICENSING PROGRAM MANAGER:
Anomeh Eivazian
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 07/08/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/08/2026


LIC809 (FAS) - (06/04)
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