198021370-3-4-2025-33-CC-SSAN-DEFVYC-20250304155055

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198021370
Report Date: 03/04/2025
Date Signed: 03/04/2025 03:51:03 PM

Document Has Been Signed on 03/04/2025 03:51 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
MONTEREY PARK CC RO, 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: 6	DATE:	03/04/2025
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	02:00 PM
MET WITH:	Armine KIrakosyan		TIME VISIT/ INSPECTION COMPLETED:	04:10 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) Shushanik Safaryan conducted an unannounced case- management licensee- initiated inspection to the above facility on 03/04/25 due to licensee is requesting capacity increase. LPA arrived at the facility at 2:00pm and met with Armine Kirakosyan , Licensee who guided analyst on a tour of the facility. Also present during this inspection was Licensee’s Assistant Rosa Guseinova. Per licensee, Armine Kirakosyan facility hours are Monday to Saturday from 7:30 a.m. to 6:30 p.m. For Large Family Child Care Home Fire Clearance was granted on 02/26/2025. 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 bathrooms , living room, dining room, den (day-care area), kitchen, detached guests house in the backyard which consists of one room, kitchen area and one bathroom, detached garage, laundry room, front yard and backyard (fenced) . There is a fireplace in the living room which has not been blocked off to prevent access to children. Per applicant, parents will enter the home through the side gate which leads to the backyard and den (day-care area). Areas that are accessible to children are as follows: Bathroom in the hallway of den, den (daycare area), one bedroom adjacent to the den and backyard (fenced). Areas off limits based on facility sketch submitted to children and parents include: Living room, dining room, two bedrooms, kitchen, detached guests house in the backyard, detached garage ,laundry room and front yard. During this inspection individuals who reside in the home were discussed and notes on Confidential Name List (LIC811) and attached to this report. Page 1 of 4

SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Shushanik Safaryan
LICENSING EVALUATOR SIGNATURE:	DATE: 03/04/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/04/2025

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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: KIRAKOSYAN FAMILY CHILD CARE	FACILITY NUMBER: 198021370
	VISIT DATE: 03/04/2025

NARRATIVE

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At 2:00 pm., Licensee took LPA on a tour of the home. LPA was toured starting from the side gate, where LPA observed latch on the gate. From the side parents enter to the den(day care area), where LPA observed children tables, chairs, toys, cubbies for their belongings. Next LPA toured the day care bedroom and observed two pack n plays and cots. LPA observed 6 napping children along with the licensee assistant. Next LPA toured children`s bathroom in the hallway and did not observe any hazards. LPA observed child safety gate separating kitchen from the day care area. LPA toured the kitchen , through the kitchen LPA toured off limit bedrooms, bathroom, living room, dining room. In the living room LPA observed fireplace, per licensee children don’t come to the off-limit areas.
Next LPA toured the backyard area. Per licensee children have two different outdoor play areas. The outdoor play areas were 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 garage door closed all the time. LPA observed detached garage door closed . Per licensee she understands garage will be off limit area and will not be used for day care. LPA observed garage used as a storage area. LPA observed turf area on the side of the yard in the front of the garage. LPA observed toys for children to play. Next LPA toured outdoor area in the back of the house, where observed toys, slides, playing structure. Next LPA, observed guest house , laundry room.
LPA observed the required 2A 10BC fire extinguisher was anchored in the day care room with the service date 01/06/2025. Licensee tested the carbon monoxide and smoke detectors . 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.
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. At 02:45pm, licensee, Armine Kiakosyan stated there are no weapons, firearms, pools, spas, hot tubs, fish ponds, or similar bodies of water on the premises. Per licensee, no animals on the premises.

The licensee was observed to be operating within the licensed capacity and is not exceeding the required limitations during this inspection. All adults present have obtained a criminal record clearance . Per licensee, currently she has only 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.

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SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Shushanik Safaryan
LICENSING EVALUATOR SIGNATURE:	DATE: 03/04/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/04/2025

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
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: KIRAKOSYAN FAMILY CHILD CARE	FACILITY NUMBER: 198021370
	VISIT DATE: 03/04/2025

NARRATIVE

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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 have completed training on preventive health practices including Pediatric First Aid and CPR. The licensee's Pediatric First Aid and CPR expires on 08/2025. Licensee, Armine KIrakosyan completed required mandated reporter training on 10/02/2023. 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.

LPA reviewed facility roster. Per roster there were 9 children enrolled . Per licensee , some children are part time ,come after school or specific days .LPA reviewed six children's records and files observed to be

complete.

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, the last drill was conducted today on 03/04/2025.

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 childcare 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.

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SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Shushanik Safaryan
LICENSING EVALUATOR SIGNATURE:	DATE: 03/04/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/04/2025

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
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: KIRAKOSYAN FAMILY CHILD CARE	FACILITY NUMBER: 198021370
	VISIT DATE: 03/04/2025

NARRATIVE

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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.

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.

Currently, the licensee is in compliance with California Code of Regulations Title 22. No deficiencies cited.

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,Armine Kirakosyan on 03/04/2025.

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SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Shushanik Safaryan
LICENSING EVALUATOR SIGNATURE:	DATE: 03/04/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/04/2025

LIC809 (FAS) - (06/04)

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