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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198021075
Report Date: 01/11/2024
Date Signed: 01/11/2024 02:54:04 PM

Document Has Been Signed on 01/11/2024 02:54 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:YEGHNANYAN FAMILY CHILD CAREFACILITY NUMBER:
198021075
ADMINISTRATOR:YEGHNANYAN, ZHANETFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(818) 818-2077
CITY:GLENDALESTATE: CAZIP CODE:
91201
CAPACITY: 14TOTAL ENROLLED CHILDREN: 3CENSUS: 2DATE:
01/11/2024
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
12:20 PM
MET WITH:Zhanet Yeghanyan, LicenseeTIME COMPLETED:
03:00 PM
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CASE MANAGEMENT INSPECTION CONDUCTED IN ARMENIAN
Licensing Program Analyst (LPA) Anomeh Eivazian conducted an unannounced case- management licensee- initiated inspection to the above facility on 01/11/24 due to licensee is requesting capacity increase. LPA arrived at the facility at 12:20 PM and met with Zhanet Yeghanyan, Licensee who guided analyst on a tour of the facility. A COVID 19 risk assessment was conducted prior to entering the facility. Also present during this inspection, was Saro Kostanyan, Licensee’s Husband. Per licensee, Zhanet Yeghanyan facility hours are Monday to Friday from 8:00 a.m. to 10:00 p.m.

For Large Family Child Care Home Fire Clearance was granted on 12/07/23.

All areas identified on the facility sketch were inspected. This is a one story home located on the first level. The home consists of 3 bedrooms, 2 restrooms, living room, kitchen, front yard, converted detached garage, bathroom inside the detached garage and backyard (fenced).
Per licensee the children use the bathroom in the hallway, living room, one bedroom adjacent to the living room, kitchen, and backyard (fenced). Per licensee areas off limits to children and parents include: Two bedrooms, one bathroom in the master bedroom, front yard, and converted detached garage. LPA did not observe stairs in the home during this inspection. 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 home through the front yard and main entrance which leads to the living room

There is a detached home in the back of the home with separated address: 1153 #A Justin Ave, Glendale , CA 91201. LPA observed there are three feet high gate in the backyard to make 1153 #A home inaccessible to the children. Per licensee, 1153 #A resident have separated commute from the back and do not trans pass from licensee's home.
REPORT CONTINUES ON NEXT PAGE 1 of 4
SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Anomeh Eivazian
LICENSING EVALUATOR SIGNATURE: DATE: 01/11/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/11/2024
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: YEGHNANYAN FAMILY CHILD CARE
FACILITY NUMBER: 198021075
VISIT DATE: 01/11/2024
NARRATIVE
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 At 12:30 pm., Licensee took this LPA on a tour of the home. LPA was toured through the interior starting with the living room. LPA observed children tables, chairs, and toys in the living room. LPA observed two children were playing in the living room with licensee. Next LPA toured the one daycare bedroom adjacent to the living room and observed children beddings in the bedroom. Next LPA toured the one daycare bathroom in the hallway of bedrooms and did not observe any hazards. Next LPA toured the two off-limit bedrooms and one off-limit bathroom in the master bedroom and did not observe any hazards. Next LPA toured the kitchen and observed child proof safety latches on the cabinets where applicant stores sharp items and cleaning compounds. LPA observed a safety gate was installed in the kitchen. Per licensee children only transpass from kitchen to go to the backyard. Per licensee, no poisons are kept in the home. LPA observed the required 2A 10BC fire extinguisher was placed on the cabinet in the kitchen. It was purchased on 09/24/2022 as read by LPA from the receipt. Fire extinguisher was not serviced annually as it is required. Licensee tested the carbon monoxide 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.

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 and 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 off-limit detached converted garage door closed all the times.

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, Zhanet Yeghanyan at 1:10 p.m there are no weapons, firearms, pools, spas, hot tubs, fish ponds, or similar bodies of water on the premises. Per licensee, there are two dogs on the premises which are inaccessible to the children.

The licensee was observed to be operating within the licensed capacity and is not exceeding the required limitations during this inspection. During this inspection two children were present in the home with licensee. All adults present have obtained a criminal record clearance on Licensing Information System (LIS). Per licensee, currently she does not have assistant. 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.
REPORT CONTINUES ON NEXT PAGE 2 of 4
SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Anomeh Eivazian
LICENSING EVALUATOR SIGNATURE:

DATE: 01/11/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/11/2024
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: YEGHNANYAN FAMILY CHILD CARE
FACILITY NUMBER: 198021075
VISIT DATE: 01/11/2024
NARRATIVE
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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 06/24. Licensee, Zhanet Yeghanyan completed required mandated reporter training on 06/16/22. Per licensee she is Armenian speaking and can not speak English. LPA informed licensee that she is exempt from Mandated Reporter training at this time due to language barrier. There are first aid supplies available on the premises. LPA advised licensee that if a child shows signs of illness he/she/they shall be separated from other children.

At 1:30 p.m., LPA asked licensee to review facility roster and it was not available for review. Per licensee currently there are three children enrolled. LPA reviewed three children's records, including emergency information from three enrolled children, and all three reviewed files were completed.

The licensee has proof of immunization against influenza, pertussis, and measles. All homes shall conduct fire and disaster drills at least once every six months, and document the date and time of each drill. Per Licensee, she has not conduct fire drill with daycare children since she has been licensed.

Emergency Disaster Plan, Parent’s Rights Poster and the Facility License were observed to be posted at the wall by the entrance. LPA did not observe the following items during the inspection: Infant Walkers, Johnny Jumpers, Saucer Chairs, Trampolines and/or any other item that fall into these categories are not permitted in a family child care facility.

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. 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 three reviewed files.

INFANT CARE: Licensee states that she provides care to infants, but currently she does not have any infants enrolled in her daycare. Licensee states that if an infant is enrolled, the infant will sleep in the daycare bedroom and living 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.
REPORT CONTINUES ON NEXT PAGE 3 of 4
SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Anomeh Eivazian
LICENSING EVALUATOR SIGNATURE:

DATE: 01/11/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/11/2024
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: YEGHNANYAN FAMILY CHILD CARE
FACILITY NUMBER: 198021075
VISIT DATE: 01/11/2024
NARRATIVE
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SAFE SLEEP: LPA discussed the safe sleep regulations with licensee, and discussed the Child Care Licensing Safe Sleep webpage at http://www.cdss.ca.gov/inforescources/child-care-licensing/public-information-and-resoucrces/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 http://www/cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment. Boppy recall: https://www.cpsc.gov/Recalls/2021/The-Boppy-Company-Recalls-Over-3-Million-Original-Newborn-Loungers-Boppy-Preferred-Newborn-Loungers-and-Pottery-Barn-Kids-Boppy-Newborn-Loungers-After-8-Infant-Deaths-Suffocation-Risk

Medication: Incidental Medical Services (IMS) policy was discussed. The licensee states that she will provide IMS. Per licensee, there are no children enrolled that require IMS at this time. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm.

LPA advised the licensee to access forms, regulations and quarterly updates online at: www.ccld.ca.gov.

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.

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, Zhanet Yeghanyan at 3:00 p.m..
REPORT END 4 of 4
SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Anomeh Eivazian
LICENSING EVALUATOR SIGNATURE:

DATE: 01/11/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/11/2024
LIC809 (FAS) - (06/04)
Page: 4 of 6
Document Has Been Signed on 01/11/2024 02:54 PM - It Cannot Be Edited


Created By: Anomeh Eivazian On 01/11/2024 at 01:18 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: YEGHNANYAN FAMILY CHILD CARE
FACILITY NUMBER: 198021075

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/11/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
01/31/2024
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 is not met as evidenced by:
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Per licensee, she will have her facility current roster available for review by 01/31/24 and a copy will be emailed to LPA Eivazian.
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During this inspection facility roster was not available for review.

This poses a potential health, safety and personal right to the children in care.
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Type B
01/31/2024
Section Cited
CCR102417(g)(1)

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Operation of A Family Child Care Home
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.

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Per licensee, she will service her fire extinguisher by 01/31/24 and a copy of service tag will be submitted to LPA via email.
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Per licensee the required 2A 10BC fire extinguisher was purchases on 09/24/2022 as read by LPA from the receipt and hasn't been serviced annually as it is required.
This poses a potential health, safety or personal rights risk to persons 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: 01/11/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/11/2024


LIC809 (FAS) - (06/04)
Page: 5 of 6
Document Has Been Signed on 01/11/2024 02:54 PM - It Cannot Be Edited


Created By: Anomeh Eivazian On 01/11/2024 at 01:25 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: YEGHNANYAN FAMILY CHILD CARE
FACILITY NUMBER: 198021075

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/11/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
01/31/2024
Section Cited
CCR
102417(g)(1)A)

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Operation of A Family Child Care Home
(A) Each family child care home shall conduct fire drills and disaster drills at least once every six months.

This requirement is not met as evidenced by:
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Per licensee, she will conduct fire drill with daycare children by 01/31/24 and a copy of fire drill log will be submitted to LPA Eivazian via email.
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Per licensee, she has not conduct any fire drill with daycare children since she has been licensed.

This poses a potential health, safety or personal rights risk to persons 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: 01/11/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/11/2024


LIC809 (FAS) - (06/04)
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