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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198021072
Report Date: 05/22/2025
Date Signed: 05/22/2025 10:34:04 AM

Document Has Been Signed on 05/22/2025 10:34 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 & POGHOSYAN FAMILY CHILD CAREFACILITY NUMBER:
198021072
ADMINISTRATOR/
DIRECTOR:		SHUSHANIK GHAZARYANFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(818) 877-9849
CITY:GLENDALESTATE: CAZIP CODE:
91201
CAPACITY: 14TOTAL ENROLLED CHILDREN: 12CENSUS: 0DATE:
05/22/2025
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:40 AM
MET WITH:Shushanik Ghazaryan, LicenseeTIME VISIT/
INSPECTION COMPLETED:
10:45 AM
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CASE MANAGEMENT INSPECTION WAS CONDUCTED IN ARMENIAN

Licensing Program Analyst, Anomeh Eivazian conducted an unannounced case management inspection to the above facility on 05/22/25 due to licensee, Shushanik Ghazaryan requested to take out her husband, Tigran Poghosyan as co-licensee from the license. LPA arrived at 9:40 AM and met with Shushanik Ghazaryan, licensee who guided analyst on a tour of the facility. During this inspection 0 children were present in the home. Per licensee, currently she has 12 after-school children enrolled in her daycare.

Licensee's husband, Tigran Poghosyan requested on 05/22/25 to be added as co-licensee to his mother license, Danelyan FCC 198021462.

During this inspection licensee, Shushanik Ghazaryan submitted an updated Application For Family Child Care Home form, LIC 279 and indicated only her name as licensee on the license.

LPA reviewed and discussed with the licensee, Shushanik Ghazaryan the following Title 22 Regulations to ensure licensee maintain compliance and meet the Title 22 regulations at all times.

Provider must reside in the home where care is being provided:

Definitions--102352 -- "Family Day Care" or "Family Child Care" means regularly provided care, protection and supervision of children, in the care giver's own home, for periods of less than 24 hours per day, while the parents or authorized representatives are away. The term "Family Child Care" supersedes the term "Family Day Care" as used in previous regulations and "Home" means the licensee's residence as defined by Government Code Section 244.


REPORT CONTINUES ON NEXT PAGE 1 of 2
NAME OF LICENSING PROGRAM MANAGER: Christina Gabelman
NAME OF LICENSING PROGRAM ANALYST: Anomeh Eivazian
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 05/22/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/22/2025
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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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: GHAZARYAN & POGHOSYAN FAMILY CHILD CARE
FACILITY NUMBER: 198021072
VISIT DATE: 05/22/2025
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Provider must be present 80% of the time providing care as stated in the following regulation:

Operation of a Family Child Care Home--102417 (a)-- The licensee shall be present in the home and shall ensure that children in care are supervised at all times. When circumstances require the licensee to be temporarily absent from the home, the licensee shall arrange for a substitute adult to care for and supervise the children during his/her absence. Temporary absences shall not exceed 20 percent of the hours that the facility is providing care per day.

Reporting Requirements--102416.2 (a) (2)--Any change in household composition including adults moving in or out of the home and anyone living in the home who reaches his or her 18th birthday.

On 05/22/25, licensee’s husband, Tigran Poghosyan submitted an application LIC279 and a written declaration that effective 05/22/25 he is going to live at 429 Sonora Ave., Glendale, CA 91201.

Per license, Shushanik Ghazaryan and her husband, Tigran Poghosyan they will fully operate separately.

- Licensee, Shushanik Ghazaryan will interact with Department staff professionally and respectfully at all times. Licensee, Shushanik Ghazaryan understands that inspections are conducted in person, unannounced, and Department staff will be granted access to the facility as part of the inspection process.

- Licensee, Shushanik Ghazaryan will be forthright with the department all the times to ensure the health and safety of children in care.

- Licensee, Shushanik Ghazaryan will be the main person to provide care to the children and interact with families.

- Licensee, Shushanik Ghazaryan will also have current children Rosters and children's files for enrollment.

During this inspection licensee, Shushanik Ghazaryan submitted a written declaration to declare that this is her only resident and does not live in another address and she does not have outside employment and will be present in the home during operation hours %80 of the time. Per licensee, she is married to Tigran Poghosyan, but they live in different addresses.

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, Shushanik Ghazaryan.


REPORT END 2 OF 2
NAME OF LICENSING PROGRAM MANAGER: Christina Gabelman
NAME OF LICENSING PROGRAM ANALYST: Anomeh Eivazian
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 05/22/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/22/2025
LIC809 (FAS) - (06/04)
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