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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198021028
Report Date: 03/19/2025
Date Signed: 03/19/2025 01:14:21 PM

Document Has Been Signed on 03/19/2025 01:14 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:POGHOSYAN FAMILY CHILD CAREFACILITY NUMBER:
198021028
ADMINISTRATOR/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 9CENSUS: 9DATE:
03/19/2025
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:30 AM
MET WITH:Anahit Poghosyan, LicenseeTIME VISIT/
INSPECTION COMPLETED:
01:30 PM
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CASE- MANAGEMENT INSPECTION CONDUCTED IN ARMENIAN

Licensing Program Analyst (LPA) Anomeh Eivazian conducted an unannounced case- management inspection to the above facility on 03/19/25 due to licensee is requesting capacity increase. LPA arrived at the facility at 11:30 AM and met with Anahit Poghosyan, Licensee who guided analyst on a tour of the facility. Also present during this inspection, was Elia Tonoian, Licensee’s Assistant. Per licensee, Anahit Poghosyan facility hours are Monday to Friday from 8:00 a.m. to 5:00 p.m..

Fire Clearance for Large Family Child Care Home was granted on 02/12/25.

Upon LPA's arrival to the facility LPA observed nine children, all (2-5 years old) were playing outside in the backyard with licensee and her assistant. The licensee was observed not to be operating within the licensed capacity and is exceeding the required limitations with three children during this inspection.

This is a one-story home located on the first level. The home consists of 2 bedrooms, 1 restroom, living room, dining room, kitchen, laundry room, front yard, and backyard (fenced). Per licensee, the children use the bathroom in the hallway, living room, dining room, kitchen, laundry room, one bedroom, and backyard (fenced). Per licensee areas off limits to children and parents include: One bedroom, and front yard. LPA did not observe any 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. Per licensee, parents enter the facility through the main entrance which leads to the living room.

All areas identified on the facility sketch that are accessible for children to use were inspected for safety, comfort, and cleanliness. At 11:30 a.m., the licensee began touring LPA’s through the home starting with the entry way which lead directly to the living room, The living room was inspected and electrical outlets were observed to be covered. LPA observed two highchairs in the living room. There is a fireplace in the living


REPORT CONTINUES ON NEXT PAGE 1 of 3
SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Anomeh Eivazian
LICENSING EVALUATOR SIGNATURE: DATE: 03/19/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/19/2025
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: POGHOSYAN FAMILY CHILD CARE
FACILITY NUMBER: 198021028
VISIT DATE: 03/19/2025
NARRATIVE
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room which has been blocked off to prevent access. Next to the living room, The dining room was inspected, and LPA observed children tables and chairs in the dining room. There is a sliding door in the dining room which leads to the balcony and Allen Street. There are wall heaters in the dining room and bedrooms hallway which have not been blocked off to prevent access. Per licensee, she installed a wall AC/heather unit in the living room, and she does not use the wall heater anymore. Next LPA toured the kitchen and observed child proof safety latches on the cabinets where licensee stores sharp items and cleaning compounds. LPA observed a child safety gate was installed to the kitchen. Per licensee, children only walk through the kitchen to go to the backyard. Next LPA toured the daycare bedroom and did not observe any hazards. LPA observed nine children napping cots with sheets on inside the daycare bedroom. Next LPA toured the off-limit one bedroom and observed licensee's personal belongings in the home. Next LPA toured the one bathroom and did not observe any hazards. Per licensee, there is no poisons kept in the home. LPA observed the required 2A 10BC fire extinguisher was anchored to the wall in laundry room. It was serviced on 12/17/24 as read by LPA from service tag. Licensee tested the carbon monoxide and smoke detectors in the hallway of bedrooms. It 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.

Next LPA toured the backyard fenced. Per licensee, children use the back yard for outdoor play time. The outdoor play area was observed to be fenced. LPA observed that the outdoor yard has toys, swings, other materials for children to play with. LPA did not observe any objects that can pose a danger to children on the outdoor yard. The licensee states that supervision is always provided. Per licensee, she keeps the backyard gate closed all the times during daycare hours and parents do not use the backyard gate to enter the facility.

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 04/2026. Licensee, Anahit Poghosyan is exempt from required mandated reporter due to language barrier. Per licensee, she is an Armenian speaking provider.

Facility roster was reviewed and was not current and completed. Per licensee currently there are 9 children enrolled. LPA reviewed 9 children's records, including emergency information from 9 enrolled children, 6 out of 9 files were available and reviewed were completed. 3 out of 9 children files were not available in the facility for review. Licensee was missing 3 children files during this inspection.


REPORT CONTINUES ON NEXT PAGE 2 of 3
SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Anomeh Eivazian
LICENSING EVALUATOR SIGNATURE:

DATE: 03/19/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/19/2025
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: POGHOSYAN FAMILY CHILD CARE
FACILITY NUMBER: 198021028
VISIT DATE: 03/19/2025
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.

LPA Eivazian informed licensee, Anahit Poghosyan that this report dated 03/19/25 documents 1 Type A citation. 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, Anahit Poghosyan to provide a copy of this licensing report dated 03/19/25 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.

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, Anahit Poghosyan.


REPORT END 3 of 3
SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Anomeh Eivazian
LICENSING EVALUATOR SIGNATURE:

DATE: 03/19/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/19/2025
LIC809 (FAS) - (06/04)
Page: 5 of 5
Document Has Been Signed on 03/19/2025 01:14 PM - It Cannot Be Edited


Created By: Anomeh Eivazian On 03/19/2025 at 11:34 AM
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: POGHOSYAN FAMILY CHILD CARE
FACILITY NUMBER: 198021028

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/19/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
03/20/2025
Section Cited
CCR
102416.5(a)

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(a) 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 is not met as evidenced by:
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Per licensee, she will disenrole 3 children effective tomorrow. An updated facility roster will be submitted to LPA Eivazian by 03/20/25.
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Upon LPA's arrival to the facility at 11:30 AM on 03/19/25, 9 children were present in the home with licensee and her assistant, all 9 children were under six years old. Licensee was out of license limitation with 3 children.
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.
SUPERVISOR'S NAME:Christina Gabelman
LICENSING EVALUATOR NAME:Anomeh Eivazian
LICENSING EVALUATOR SIGNATURE:
DATE: 03/19/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/19/2025


LIC809 (FAS) - (06/04)
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Document Has Been Signed on 03/19/2025 01:14 PM - It Cannot Be Edited


Created By: Anomeh Eivazian On 03/19/2025 at 11:42 AM
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: POGHOSYAN FAMILY CHILD CARE
FACILITY NUMBER: 198021028

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/19/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/20/2025
Section Cited
CCR
102417(g)(8)

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Operation of a Family Child Care Home
Each family child care home shall have a current roster of children as specified in Health and Safety Code Section 1596.841.
This requirement was not met as evidence by...
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Per licensee, she will update her facility roster by 03/20/25 and a copy will be emailed to LPA.
LPA asked licensee to document all present 9 children names on the roster and identify whom she disenrolled as of 03/20/25.
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During this inspection facility roster was reviewed and it was not current.
This poses a potential health, safety and personal right risk to the children in care.
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Type B
03/28/2025
Section Cited
CCR102421(b)

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Child's Records
The licensee shall maintain, in each child's record, a copy of the emergency information card as required
in Section 102417(g)(7).

This requirement is not met as evidenced by:
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Per licensee, she will have all children files available for review by 03/28/25.
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During this inspection 9 children were present in the facility and licensee only had 6 children files available for review. 3 out of 9 present children files were not available for review.
This poses a potential 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.
SUPERVISOR'S NAME:Christina Gabelman
LICENSING EVALUATOR NAME:Anomeh Eivazian
LICENSING EVALUATOR SIGNATURE:
DATE: 03/19/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/19/2025


LIC809 (FAS) - (06/04)
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