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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198021676
Report Date: 02/21/2025
Date Signed: 02/21/2025 11:38:48 AM

Document Has Been Signed on 02/21/2025 11:38 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
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:KARAPETYAN FAMILY CHILD CAREFACILITY NUMBER:
198021676
ADMINISTRATOR/
DIRECTOR:		KARAPETYAN, IRINAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(818) 484-1283
CITY:GLENDALESTATE: CAZIP CODE:
91203
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 0DATE:
02/21/2025
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:58 AM
MET WITH:Irina Karapetyan TIME VISIT/
INSPECTION COMPLETED:
11:45 AM
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PRELICENSING INSPECTION CONDUCTED IN ARMENIAN

Licensing Program Analyst (LPA) Shushanik Safaryan conducted an announced pre-licensing inspection to the above facility on 02/21/2025. Upon arrival , at 09:00 am LPA met with Irina Karapetyan, applicant who guided analyst on a tour of the facility. Pre-licensing Entrance Checklist (LIC9280) was provided to applicant. During this inspection individuals who reside in the home were discussed and notes on Confidential Name List (LIC811) and attached to this report. Per applicant operation hours will be Monday to Friday , 7:00a.m. to 11:30 p.m. Applicant states she will care for children 6 months -13 years old.
Licensee requesting a change of location. Fire clearance was approved 02/18/2025. Licensee was previously licensed as a large family childcare with facility number 198018988 at 1512 E. Harvard st, Glendale, Ca 91205.

All areas identified on the facility sketch were inspected. This is a one-story home .Home consists of 2 bedrooms , 1 bathroom, living room, dining room, den, kitchen , detached garage, basement, backyard (fenced). Children will have access to the living room, dining room, bathroom, kitchen, two bedrooms, backyard. Children and parents will not have access to the den area, basement , detached garage.**Rooms that are off-limits need to be made inaccessible during operating hours**

At 09:00 am, the applicant began touring LPA through the home starting with the entry way which led directly to the living room. There is a screen door with (2) locks on the front entrance. LPA observed door alarm on the main entrance door for the additional safety. In the living room LPA observed fireplace blocked off to prevent children access. LPA observed all electrical outlets were covered. Per applicant parents will enter home from the main entrance where she will put required information on the wall. Next LPA toured dining room where observed table and chairs. From the dining room LPA observed door to the den area. Per applicant den area will be inaccessible to the children. LPA observed child safety latch on the door. From the living room children will have access to the bathroom located in the hallway and bedrooms. Page 1 of 6

SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Shushanik Safaryan
LICENSING EVALUATOR SIGNATURE: DATE: 02/21/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/21/2025
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 6
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: KARAPETYAN FAMILY CHILD CARE
FACILITY NUMBER: 198021676
VISIT DATE: 02/21/2025
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 In the bathroom , LPA observed child safety latch on the cabinet under the sink and did not observe any hazards. Tour continued to the bedroom #1 that will be used for children. LPA observed children`s cots and the door to the closet . In the closet LPA observed day care supplies. Per licensee that closet will be used only to store day care supplies. Next LPA toured bedroom #2 . Per applicant bedroom #2 will be for her personal use, where she will have her bed. In the closet ,LPA observed applicant`s personal belongings and no hazards observed on this day. Next LPA toured the kitchen , where observed child safety latch on the cabinet under the sink and where sharp items stored. LPA observed required 2A 10BC fire extinguisher was anchored to the wall in the kitchen with the service date read from the service tag by LPA 11/25/2024. Smoke detector and carbon monoxide observed in the dining room and were tested by applicant and heard by LPA to be operable. In the kitchen, LPA observed child safety gate and child safety knob to the door that leads outside to the backyard area. Per licensee children will use this door to go to the yard. Outdoor area fenced and gated. LPA observed latch on the gates. LPA observed gate leading to the basement area. LPA toured basement area , that is used as a storage and did not observe any hazards. Per licensee gate to the basement and basement door will be locked during the day care hours. LPA observed 2 locks on the gate. Next LPA toured detached garage and did not observe any hazards. Per licensee garage is used as a storage area. LPA observed lock on the garage door and per applicant it will be locked during the day care hours. LPA observed grass area , lemon tree. LPA observed AC unit was gated to prevent children access. No bodies of water observed during this inspection. The applicant states that supervision will be always provided.

The applicant states that she will provide food for children in care. Applicant 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 applicant, at 10:00 am, there are no pets, weapons, firearms, or bodies of water on the premises. There are toys available for children. There is telephone service via cellphone will be used and will stay at the facility during operation hours. LPA advised applicant that if a child shows signs of illness, he/she/they shall be separated from other children. Per applicant no one smokes in the home. There is first aid kit located in the kitchen cabinet.



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SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Shushanik Safaryan
LICENSING EVALUATOR SIGNATURE:

DATE: 02/21/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/21/2025
LIC809 (FAS) - (06/04)
Page: 2 of 6
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: KARAPETYAN FAMILY CHILD CARE
FACILITY NUMBER: 198021676
VISIT DATE: 02/21/2025
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Applicant has proof of CPR and First Aid training as indicated on the certificate. The applicant does have proof of Health and Safety training, Pediatric First Aid and CPR . The applicants Pediatric First Aid and CPR certificate expires on 09/2025. The applicant has proof of immunization against influenza, pertussis, and measles.
Applicant completed required mandated reporter training and has a certificate with the issue date 12/02/2024. Mandated reporter training must be completed every 2 years. www.mandatedreporterca.com

Because the applicant rents/leases the home, proof of landlord notification is required. The LPA observed the Property Owner/Landlord Notification form (LIC9151) that the applicant confirms was provided to the property owner/landlord. The applicant obtained a signed Property Owner/Landlord Consent form (LIC 9149).

The following was discussed with the applicant:
Applicant was reminded that all adults 18 and over living in the home, persons who provide care and supervision to children, and staff who have contact with children, 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 Childcare 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.

-In the absence of the licensee a qualified adult must be present supervising the children; a qualified adult is an individual who has a valid and current adult/infant CPR & Pediatric First Aid certification and a valid criminal record clearance associated to the facility license.


-A current roster of children enrolled must be available and maintained for a period of three years, even after children no longer are attending the facility.
-Annual fees must be paid promptly and by the due date or a late fee shall be assessed and/or the License shall be terminated.
-The fire extinguisher type 2A-10BC must be serviced annually or as often as necessary and smoke and carbon monoxide detectors should check, and batteries replaced as needed.
-Changes should be reported to the Department as soon as they occur such as construction, remodeling, telephone number changes and/or if you move from your home.
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SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Shushanik Safaryan
LICENSING EVALUATOR SIGNATURE:

DATE: 02/21/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/21/2025
LIC809 (FAS) - (06/04)
Page: 3 of 6
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: KARAPETYAN FAMILY CHILD CARE
FACILITY NUMBER: 198021676
VISIT DATE: 02/21/2025
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-Any unusual incidents or injuries must be reported to the Department within 24 hours via telephone and within seven (7) days in writing. (Use LIC624B for written report)
-Fire and safety drills must be performed every six months and documented for review by the Department.
-Smoking is prohibited in a family childcare home.
-Children and Staff records must be maintained and updated as needed and must be available for review by the Department.
-Dog(s) and or pets are recommended to be isolated from children in care.
-No smoking, no infant walkers, No Johnny jumpers, no saucer chairs, no trampolines and any other item that falls into that category are not permitted in the facility. -All adults living and working in the home shall be made of aware of the Departments right to inspection authority, which includes but not limited to the right to enter the home when children are being cared for, interview children and adults and review documentation. Applicant shall reveal each facility license number in all advertisements, publications, or announcements with the intent to attract clients.

- Emergency Disaster Plan, Parent’s Rights Poster and the Facility License are required to be posted.

INFANT CARE: Applicant states that she will care for infants. Applicant states that infants will sleep in the playroom where they are constantly supervised. Appropriate sleeping arrangements and cribs will be available once an infant being enrolled. LPA informed one crib for each infant in care will be needed. Cribs or play yard shall 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 shall be free of loose articles and objects. No objects shall be hanging above or attached to the side of the crib. LPA informed Applicant infants cannot be swaddled while in care. LPA advised the Applicant 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 Applicant. LPA provided the Applicant with a copy of A Childcare 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.



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SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Shushanik Safaryan
LICENSING EVALUATOR SIGNATURE:

DATE: 02/21/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/21/2025
LIC809 (FAS) - (06/04)
Page: 4 of 6
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: KARAPETYAN FAMILY CHILD CARE
FACILITY NUMBER: 198021676
VISIT DATE: 02/21/2025
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SAFE SLEEP: LPA discussed the safe sleep regulations with applicant and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed applicant of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.
APPLICANT WILL WAIT UNTIL FACILITY OPENS TO DETERMINE IMS NEEDS:
Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. 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) or (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Childcare Centers and the ADA, available at: http://www.ada.gov/childqanda.htm.

Per applicant, there are no dual licenses at this address. Applicant’s email address was obtained during this inspection. The applicant was advised that email may be public information.


Per applicant, she does not carry liability insurance or a bond in accordance with standard established by Family Childcare statue. Signed statements (LIC282) will be on children’s files. The law requires Family Childcare provider to carry liability insurance or bond in the amount of $300,000 annually or to maintain the signed statement in the facility file.

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platform.

To receive important licensed-related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

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SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Shushanik Safaryan
LICENSING EVALUATOR SIGNATURE:

DATE: 02/21/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/21/2025
LIC809 (FAS) - (06/04)
Page: 5 of 6
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: KARAPETYAN FAMILY CHILD CARE
FACILITY NUMBER: 198021676
VISIT DATE: 02/21/2025
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Megan’s Law - Family Childcare Homes On this date, 02/06/2025 the California Attorney General - Megan’s Law website was searched for information on sex offenders required to register with local law enforcement under California's Megan's Law. No registered sex offenders were found at the facility addresses. Under state law, some registered sex offenders are not subject to public disclosure; therefore, they may not have been included in this search. However, the Department conducts a monthly cross reference of each address on record for all registered sex offenders against all CCLD facility addresses pursuant to information shared by California DOJ.

MyChildCarePlan.org--Child Care Centers and Family Childcare Home [Applicant, or Licensee] was informed of the MyChildCarePlan.org site, a consumer education website that helps families obtain childcare by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California

LPA reviewed with applicant the LIC 311D, Forms/Records to Keep in Your Family Childcare Homes, children’s forms/records, facility forms/records, and information to be posted. Entrance checklist was provided to the applicant.

Once licensed, the applicant is required to adhere to the terms and limitations stated on the license.


The applicant’s signature on this report acknowledges that they have signed the Application for a Family Childcare Home License (LIC 279) under the penalty of perjury that the statements on the application and any attachments are correct.
Exit interview conducted and report was reviewed with the applicant, Irina Karapetyan on 02/21/2025.

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SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Shushanik Safaryan
LICENSING EVALUATOR SIGNATURE:

DATE: 02/21/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/21/2025
LIC809 (FAS) - (06/04)
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