198021125-1-25-2024-33-CC-AEIN-CZTQWW-20240125113233

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198021125
Report Date: 01/25/2024
Date Signed: 01/25/2024 11:36:30 AM

Document Has Been Signed on 01/25/2024 11:36 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:	HAKOBYAN FAMILY CHILD CARE		FACILITY NUMBER:	198021125
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 7	CENSUS: 5	DATE:	01/25/2024
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME BEGAN:	08:35 AM
MET WITH:	Arpik Hakobyan, Licensee		TIME COMPLETED:	11:30 AM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	CASE MANAGEMENT INSPECTION CONDUCTED IN ARMENIAN Licensing Program Analyst (LPA) Anomeh Eivazian conducted an unannounced case- management inspection to the above facility on 01/25/24 due to licensee is requesting capacity increase. LPA arrived at the facility at 8:35 AM and met with Arpik Hakobyan, 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 Liparit Hambarzumyan, Licensee’s Assistant/Son. Per licensee, Arpik Hakobyan facility hours are Monday to Friday from 7:00 a.m. to 10:00 p.m. For Large Family Child Care Fire Clearance was granted on 12/15/23. This is a one story home located on the first level. The home consists of 3 bedrooms, 2 restrooms, living room, kitchen, detached garage, front yard and back yard (fenced). Per licensee, parents enter the home from the main entrance which leads to the living room and side gate which leads to the backyard. Per licensee the children use the bathroom in the hallway, living room (main day care area), one bedroom adjacent to the living room, kitchen, front part of backyard (fenced), and detached garage for limited activity only. Per licensee areas off limits to children and parents include: Two bedrooms in the hallway, one bathroom in the master bedroom, front yard, and back of back yard (patio). During this inspection LPA did not observe 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, children use the detached garage for limited activity only anytime from 9:30 AM-12:00 PM and 3:00 PM to 5:00 PM. Per licensee, children do not eat or sleep inside the detached garage. Per licensee, children eat and sleep inside the main home. REPORT CONTINUES ON NEXT PAGE 1 of 4

SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Anomeh Eivazian
LICENSING EVALUATOR SIGNATURE:	DATE: 01/25/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/25/2024

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 4

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: HAKOBYAN FAMILY CHILD CARE	FACILITY NUMBER: 198021125
	VISIT DATE: 01/25/2024

NARRATIVE

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All areas identified on the facility sketch that are accessible for children to use were inspected for safety, comfort, and cleanliness. At 8:45 am, the licensee began touring LPA’s through the home starting with the entry way which lead directly to the living room (main day care area). The living room was inspected and electrical outlets were observed to be covered. LPA observed sofas, a dining table, four adult chairs, children tables and chairs and toys in the living room. LPA observed five children were playing with licensee and her assistant. LPA observed children safety latch, and chain lock on the main entrance door. Next to the living room, The kitchen was inspected, and LPA observed child proof safety latches on the cabinets where licensee stores cleaning compounds and sharp items. Per Licensee, the medications are stored in a cabinet out of reach for children. LPA advised that should the licensee have older children in care that may reach the cabinet, that they be secured. There is a door in the kitchen which leads to the backyard. Next LPA toured the one daycare bedroom adjacent to the living room and observed a bed and children napping cots. Next LPA toured the bathroom in the hallway and did not observe any hazards. LPA observed child proof safety latches on the cabinet under the sink where licensee stores cleaning compounds and personal hygiene. Next LPA toured the two off-limit bedrooms and one off-limit bathroom in the master bedroom and did not observe any hazards. LPA observed plastic door knobs on off-limit areas door knobs. Per licensee, no poisons are kept in the home. LPA observed the required 2A 10BC fire extinguisher was anchored to the wall by the entrance door in the living room. It was serviced on 01/25/24 as read by LPA from the service tag. Licensee tested the carbon monoxide and smoke detectors in the living room. 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 front park of 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. LPA observed the backyard ground was covered with outdoor carpet. The Licensee states that supervision is always provided. Next LPA toured the off-limit back of the backyard (patio) and did not observe any hazards. LPA observed off-limit areas in the backyard was separated by 6 feet high fencing. Next LPA toured the detached garage for limited activity only and observed children toys, tables and chairs in the detached garage. LPA did not observe any hazards in the detached garage.

REPORT CONTINUES ON NEXT PAGE 2 of 4

SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Anomeh Eivazian
LICENSING EVALUATOR SIGNATURE:	DATE: 01/25/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/25/2024

LIC809 (FAS) - (06/04)

Page: 2 of 4

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: HAKOBYAN FAMILY CHILD CARE	FACILITY NUMBER: 198021125
	VISIT DATE: 01/25/2024

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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, Arpik Hakobyan at 10:13 a.m there are no pets, weapons, firearms, pools, spas, hot tubs, fish ponds, or similar bodies of water on the premises.

The licensee was observed to be operating within the licensed capacity and is not exceeding the required limitations during this inspection. During this inspection five 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 has one 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.

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 08/24. Licensee, Arpik Hakobyan completed required mandated reporter training on 12/23/23. 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 10:20 a.m., facility roster was reviewed and completed. Per licensee currently there are seven children enrolled. LPA reviewed seven children's records, including emergency information from seven enrolled children, and all seven 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. Last drill documented was conducted on 12/11/23. 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.

REPORT CONTINUES ON NEXT PAGE 3 of 4

SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Anomeh Eivazian
LICENSING EVALUATOR SIGNATURE:	DATE: 01/25/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/25/2024

LIC809 (FAS) - (06/04)

Page: 3 of 4

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: HAKOBYAN FAMILY CHILD CARE	FACILITY NUMBER: 198021125
	VISIT DATE: 01/25/2024

NARRATIVE

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Smoking is prohibited in a licensed Family Child Care Home. Per Licensee, no one smokes in the home. There is telephone service via a landline that is used and 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 seven reviewed files.

INFANT CARE: Licensee states that she is provides care for infant. Per licensee, currently she has one infant enrolled in her day care who is 23 months old. Licensee states that infants sleep in living room and one daycare bedroom 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.

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.

At this time, the licensee is in compliance with California Title 22 Regulations. Therefore, there are no citations being issued today from the areas that were inspected today.

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, Arpik Hakobyan at 11:30 a.m..

REPORT END 4 of 4

SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Anomeh Eivazian
LICENSING EVALUATOR SIGNATURE:	DATE: 01/25/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/25/2024

LIC809 (FAS) - (06/04)

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