198021147-3-30-2023-33-CC-AEIN-CQET8B-20230330143003

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198021147
Report Date: 03/30/2023
Date Signed: 03/30/2023 02:30:15 PM

Document Has Been Signed on 03/30/2023 02:30 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:	NAZEYAN FAMILY CHILD CARE		FACILITY NUMBER:	198021147
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 6	CENSUS: 6	DATE:	03/30/2023
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME BEGAN:	11:15 AM
MET WITH:	Roza Nazeyan, Licensee		TIME COMPLETED:	02:45 PM

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 03/30/23 due to the licensee is requesting capacity increase. LPA arrived at the facility at 11:15 AM and met with Roza Nazeyan, 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 Zinaida Hovhannisyan, Licensee’s Assistant. Per licensee, Roza Nazeyan facility hours are Monday to Friday from 7:00 a.m. to 11:00 p.m. Fire clearance for Large Family Child Care Home was granted on 03/14/2023. This is a one story home located on the first level. The home consists of 3 bedrooms, 1 and 1/2 restrooms, living room, dining room, kitchen, detached garage and storage in the backyard, front yard, and backyard (fenced). There is a fireplace in the living room which has been blocked off to prevent access to children. Per licensee, parents will enter the facility through the side gate which leads to the backyard and daycare area. Per licensee the children use the Half Bathroom in the kitchen, dining room, two bedrooms, kitchen, play areas in the backyard. Per licensee areas off limits to children and parents include: Living room, one bedroom, one bathroom, front yard, detached garage, storage in the backyard, and off-limit areas in the backyard. During this inspection individuals who reside in the home were discussed and notes on Confidential Name List (LIC811) and attached to this report. All areas identified on the facility sketch that are accessible for children to use were inspected for safety, comfort, and cleanliness. At 11:45 am, the licensee began touring LPA’s through the home starting with the entry way which lead directly to the living room, The off-limit living room was inspected and electrical outlets were observed to be covered. LPA observed a sliding baby gate was installed between living room and dining REPORT CONTINUES ON NEXT PAGE 1 of 5

SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Anomeh Eivazian
LICENSING EVALUATOR SIGNATURE:	DATE: 03/30/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/30/2023

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: NAZEYAN FAMILY CHILD CARE	FACILITY NUMBER: 198021147
	VISIT DATE: 03/30/2023

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room to make the living room inaccessible to the children. Next to the living room, the dining room was inspected and LPA observed children tables, chairs, toys and a piano in the dining room. Next the kitchen was inspected, and LPA observed child proof safety latches on the cabinets where licensee stores cleaning compounds and sharp items. Per licensee, children walk through the kitchen to go the daycare area. Next LPA toured the half bathroom adjacent to the kitchen and did not observe any hazards. Next LPA toured the daycare bedroom (day care play area) and observed children tables, chairs, and toys in the daycare playarea. There is door in the bedroom (daycare play area)which leads to the backyard. Next LPA toured the daycare bedroom in the hallway and observed 1 pack n' play and napping cots. Next LPA toured the off-limit bathroom in the hallway and did not observe any hazards. Next LPA toured the off-limit bedroom and observed a bed and licensee's family personal belongings in the bedroom. Per licensee no poisons are kept in the home. LPA observed the required 2A 10BC fire extinguisher was placed on the floor in the kitchen. It was purchased on 12/04/2022 as read by LPA from the receipt. Licensee tested the carbon monoxide and smoke detectors in the dining 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 gated playarea in the backyard for outdoor play time. LPA observed off-limit areas in the backyard is gated to prevent access of the children to off-limit areas. 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. Next LPA toured the off-limit detached garage and storage in the backyard and did not observe any hazards. Per licensee, garage and storage doors are kept closed and locked all the times during daycare hours.

Per Licensee, Roza Nazeyan at 12:40 p.m there are no pets, weapons, firearms, pools, spas, hot tubs, fish ponds, or similar bodies of water on the premises.

REPORT CONTINUES ON NEXT PAGE 2 of 5

SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Anomeh Eivazian
LICENSING EVALUATOR SIGNATURE:	DATE: 03/30/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/30/2023

LIC809 (FAS) - (06/04)

Page: 2 of 5

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: NAZEYAN FAMILY CHILD CARE	FACILITY NUMBER: 198021147
	VISIT DATE: 03/30/2023

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The licensee was observed to be operating within the licensed capacity and is not exceeding the required limitations during this inspection. During this inspection LPA observed 6 children were present in the home, 3 being infants, with licensee and her assistant. All adults present have obtained a criminal record clearance on Licensing Information System (LIS). Per licensee, currently she has 1 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 02/2025. Licensee, Roza Nazeyan completed required mandated reporter training on 06/10/2021. There are first aid supplies available on the premises in the kitchen. LPA advised licensee that if a child shows signs of illness he/she/they shall be separated from other children.

At 1:00 p.m., facility roster was reviewed and completed. Per licensee currently there are 6 children enrolled. LPA reviewed 6 children's records, including emergency information from 6 enrolled children, and all 6 reviewed files were completed.

The licensee and her assistant have 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, her day care has been opened since 01/2023 which is less than six months.

Emergency Disaster Plan, Parent’s Rights Poster and the Facility License were observed to be posted at the wall in daycare playarea. 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 5

SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Anomeh Eivazian
LICENSING EVALUATOR SIGNATURE:	DATE: 03/30/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/30/2023

LIC809 (FAS) - (06/04)

Page: 3 of 5

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: NAZEYAN FAMILY CHILD CARE	FACILITY NUMBER: 198021147
	VISIT DATE: 03/30/2023

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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 cellphone that is used and the cellphone stays at the facility during operation hours. Per licensee she carries liability insurance in accordance with standard established by Family Child Care statue.

INFANT CARE: Licensee states that she provides care to infants. Per licensee, currently there are 3 infants enrolled in her daycare but only one infant is taking nap while in daycare, two other enrolled infants are part time and do not take nap while in daycare Licensee states that infants sleep in the daycare bedroom where they are constantly supervised. Appropriate sleeping arrangements and cribs were observed. (one crib for each infant in care was observed). Cribs or play yard did not hinder the entrance or exit from the sleeping space, mattresses shall be firm and covered with a fitted sheet that overlaps the underside so it cannot be dislodged. Cribs and play yards were observed to be free of loose articles and objects. No objects were observed to be hanging above or attached to the side of the crib. LPA did not observe any infants swaddled while in care. 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. LPA provided the licensee with a copy of A Child Care Provider’s Guide to Safe Sleep, by American Academy of Pediatrics. LPA also consulted and explained Child Abuse Reporting, Never Shake a Baby, and Safe Sleeping practices.

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

REPORT CONTINUES ON NEXT PAGE 4 of 5

SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Anomeh Eivazian
LICENSING EVALUATOR SIGNATURE:	DATE: 03/30/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/30/2023

LIC809 (FAS) - (06/04)

Page: 4 of 5

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: NAZEYAN FAMILY CHILD CARE	FACILITY NUMBER: 198021147
	VISIT DATE: 03/30/2023

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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, Roza Nazeyan at 2:45 p.m..

REPORT END 5 of 5

SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Anomeh Eivazian
LICENSING EVALUATOR SIGNATURE:	DATE: 03/30/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/30/2023

LIC809 (FAS) - (06/04)

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