343624016-1-16-2025-03-CC-ASUR-DCYSP9-20250116130245

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 343624016
Report Date: 01/16/2025
Date Signed: 01/16/2025 01:03:09 PM

Document Has Been Signed on 01/16/2025 01:03 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
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME:	TAMOYAN, LUSINE		FACILITY NUMBER:	343624016
ADMINISTRATOR/ DIRECTOR:	TAMOYAN, LUSINE		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(916) 248-6068
CITY:	SACRAMENTO	STATE: CA	ZIP CODE:	95827
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS: 1	DATE:	01/16/2025
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	11:30 AM
MET WITH:	Lusine Tamoyan		TIME VISIT/ INSPECTION COMPLETED:	01:15 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	On Thursday, January 16, 2025, Licensing Program Analysts (LPAs) Amanda Sutter and Payenda Seddiqi met with Licensee, Lusine Tamoyan, for the purpose of an unannounced annual inspection. Upon arrival, LPA observed licensee supervising 1 infant child. No other adults were present at the facility. All individuals subject to criminal background review have obtained a criminal record clearance. LPAs observed proper ratio and capacity was being followed. Facility hours of operation are Monday to Friday, 7:00 AM to 10:00 PM, and Saturday to Sunday from 8:00 AM to 6:00 PM. A health and safety evaluation was conducted in all areas accessible to children. Off-limit areas include: entire upstairs and garage. Licensee acknowledged that children may never enter these off-limit areas. LPA observed that the facility is clean, safe, sanitary, and in good repair. LPAs observed a functioning smoke detector, carbon monoxide detector, and a full 2A10BC fire extinguisher. The facility has adequate toys that appear to be safe for children to use. The licensee stated there are no weapons in the home. LPAs observed a fireplace and stairs to be barricaded according to regulation. LPAs did not observe any bodies of water at the facility. The backyard is fenced. LPAs reviewed five children’s files. LPAs did not observe the LIC700 in 4 of 5 files reviewed, and did not observe the LIC627 in 3 of 5 files reviewed. Required postings and the children’s roster were observed. LPAs reviewed 15-minute observation checks for napping infants. The facility has record of conducting fire drills at least every 6 months. The last fire drill was conducted 12/20/2024. Licensee’s CPR/First Aid card expires 7/2026. Licensee’s Mandated Reporter certificate expires 1/28/2025. Licensee understands that trainings must be completed every two years. LPAs verified that the annual fees are current. Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California. *PAGE 1. REPORT CONTINUES ON LIC809-C*

SUPERVISORS NAME: Seychelle De Luca
LICENSING EVALUATOR NAME: Amanda Sutter
LICENSING EVALUATOR SIGNATURE:	DATE: 01/16/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/16/2025

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
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: TAMOYAN, LUSINE	FACILITY NUMBER: 343624016
	VISIT DATE: 01/16/2025

NARRATIVE

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LPAs discussed the safe sleep regulations with licensee 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. LPAs also informed licensee 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.

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)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: https://www.ada.gov/resources/child-care-centers/.

Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.

Based on the inspection, two Type B citations have been issued.

A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the licensee Lusine Tamoyan. During the exit interview, the Licensee Lusine Tamoyan, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS. Appeal Rights were provided.

SUPERVISORS NAME: Seychelle De Luca
LICENSING EVALUATOR NAME: Amanda Sutter
LICENSING EVALUATOR SIGNATURE:	DATE: 01/16/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/16/2025

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 01/16/2025 01:03 PM - It Cannot Be Edited

Created By: Amanda Sutter On 01/16/2025 at 12:41 PM

Link to Parent Document Below:

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: TAMOYAN, LUSINE	FACILITY NUMBER: 343624016
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 01/16/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

102421(b)

Child's Records

(b) The licensee shall maintain, in each child's record, a copy of the emergency information card as required in Section 102417(g)(7). This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensee did not have the LIC700 in 4 of the 5 files reviewed, which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 02/14/2025
	Plan of Correction
1 2 3 4	Licensee will submit completed LIC700s to LPA by date listed above.

Type B

Section Cited

CCR

102417(g)(7)

Operation of A Family Child Care Home

(7) An emergency information card shall be maintained for each child and shall include the child's full name, telephone number and location of a parent or other responsible adult to be contacted in an emergency, the name and telephone number of the child's physician and the parent's authorization for the licensee or registrant to consent to emergency medical care. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensee did not have the LIC627 for 3 of the 5 files reviewed, which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 02/14/2025
	Plan of Correction
1 2 3 4	Licensee will submit completed LIC627 to LPA by date listed above.

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME:

Seychelle De Luca

LICENSING EVALUATOR NAME:

Amanda Sutter

LICENSING EVALUATOR SIGNATURE:

DATE: 01/16/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/16/2025

LIC809 (FAS) - (06/04)

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