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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198020824
Report Date: 08/19/2021
Date Signed: 08/19/2021 02:08:59 PM

Document Has Been Signed on 08/19/2021 02:08 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:MUSHEGHYAN FAMILY CHILD CAREFACILITY NUMBER:
198020824
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
08/19/2021
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
12:20 PM
MET WITH:Atryom Musheghyan, ApplicantTIME COMPLETED:
02:20 PM
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PRELICENSING INSPECTION CONDUCTED IN ARMENIAN

Licensing Program Analyst (LPA) Anomeh Eivazian conducted an announced pre-licensing follow up inspection to the above facility on 08/19/2021. LPA arrived at the facility at 12:20 PM and met with Artyom Musheghyan, Applicant who guided analyst on a tour of the facility.

Per applicant operation hours will be Monday to Friday, 7:00 a.m. to 6:00 p.m.. Applicant states she will care for children 0-12 years old.

The following corrections was observed during this inspection:
1. Applicant fully moved to this address and and LPA observed applicant's personal belongings in the home. LPA toured the living room and dining room and observed a sofa, a coffee table, a dining room, and dining chairs in the living room and dining room. LPA toured the bedroom and observed a full size bed and applicant's personal belongings in the bedrooms. Applicant submitted a written declaration regarding who lives in the home. Per applicant he lives in this address. Pictures were taken.
2. Applicant submitted a written plan to share the backyard (fenced) on staggered scheduled with Anahit Beglaryng, applicant next door with facility number 198020837. Applicant will use the backyard from 11:45 a.m. to 1:00 p.m.and from 4:15 p.m. and 6:00 p.m., and Anahit Beglaryan at 363 W. Acacia, Glendale, CA 91204 will use the backyard from 10:00 a.m. to 11:30 a.m. and 2:30 p.m. to 4:00 p.m.. Per applicant, his daycare children will not commingle with Anahit Beglaryan daycare at any time.
3. Applicant added railing to the stairs which leads to the backyard.
4. LPA observed toys available in the home.
5. Applicant observed emergency supplies available in the home in the kitchen cabinet.
6. Applicant submitted an updated facility sketch and included 363 W. Acacia home in the sketch.
7. A working telephone via cellphone that will stay in the home all the times is available in the home.
REPORT CONTINUES ON NEXT PAGE 1 of 2
SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Anomeh Eivazian
LICENSING EVALUATOR SIGNATURE: DATE: 08/19/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/19/2021
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 2
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: MUSHEGHYAN FAMILY CHILD CARE
FACILITY NUMBER: 198020824
VISIT DATE: 08/19/2021
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LPA informed applicant that his daycare enrolled children and parents are required to be clear that they are enrolled at this facility and Artyom Musheghyan is the licensee and care giver. Applicant agreed to have his facility address on top of Children Identification and Emergency Information form (LIC700) .

A small family child care license will be granted upon receipt of proof of corrections for the above. Once licensed, the applicant is required to adhere to the terms and limitations stated on the license.

The applicant’s signature on this report acknowledges that they have signed the Application for a Family Child Care Home License (LIC 279) under the penalty of perjury that the statements on the application and any attachments are correct.

Exit interview conducted and report was reviewed with the Applicant, Artyom Musheghyan at 2:20 p.m..

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

DATE: 08/19/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/19/2021
LIC809 (FAS) - (06/04)
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