198021370-7-23-2024-33-CC-AEIN-D7FTP8-20240723145356

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198021370
Report Date: 07/23/2024
Date Signed: 07/23/2024 02:53:58 PM

Document Has Been Signed on 07/23/2024 02:53 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:	KIRAKOSYAN FAMILY CHILD CARE		FACILITY NUMBER:	198021370
ADMINISTRATOR/ DIRECTOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 8	CENSUS: 7	DATE:	07/23/2024
TYPE OF VISIT:	Case Management - Other	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	02:15 PM
MET WITH:	Armine Kirakosyan, Licensee		TIME VISIT/ INSPECTION COMPLETED:	03:00 PM

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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 07/23/24 to ensure Type A and B deficiencies cited on 06/17/24 have been cleared. LPA arrived at 2:15 PM and met with Armine Kirakosyan who guided analyst on a tour of the facility. During this inspection there were 7 children present in the home, one being six years old, sleeping in the daycare area. Also, Roza Guseinova, licensee’s assistant was present in the home. The following has been observed:

- Staff ratio and capacity has been met. During this inspection, there were 7 children children in care, one being six years old.
- All adults present in the daycare have criminal record clearance in Licensing Information System.
- Current roster of children was provided.
- Licensee's assistant, Roza Guseinova has TB Test Clearance on file.
- LPA reviewed 8 children files during this inspection and completed.

Acknowledgement forms were observed for all children in care.

LPA advised the licensee how to access forms, regulations and quarterly updated on the Child Care Licensing Website at: www.ccld.ca.gov.

LPA cleared deficiencies on this date and provided a copy of the Licensing Report to Licensee, and issued POC clearance letter.
The Notice of Site Visit (LIC 9213) was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the Armine Kirakosyan.

SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Anomeh Eivazian
LICENSING EVALUATOR SIGNATURE:	DATE: 07/23/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/23/2024

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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