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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343624714
Report Date: 03/06/2023
Date Signed: 03/06/2023 10:18:04 AM

Document Has Been Signed on 03/06/2023 10:18 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
RIVER CITY (SACTO)CC, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833
FACILITY NAME:MOVSISYAN, HASMIKFACILITY NUMBER:
343624714
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 0DATE:
03/06/2023
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
08:45 AM
MET WITH:Hasmik (Amy) MovsisyanTIME COMPLETED:
10:30 AM
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On March 6th, 2022, Licensing Program Analysts (LPAs) Soleil Marx and Erwina Pascual-Golamco met with Licensee Hasmik (Amy) Movsisyan, for the purpose of an unannounced case management inspection. Licensee has requested to increase from a small family childcare to a large family childcare. Upon LPA's arrival the licensee was the only person in the home, there were no children in care. LPA verified with Licensee that her current associations are accurate.

A health and safety inspection was conducted in all areas accessible to children. Off limit areas remain the same which include: entire upstairs, downstairs bedroom, and garages. Licensee acknowledges that she must contact Community Care Licensing prior to making an off-limit area on-limits and vice versa. A Fire Safety Inspection Clearance (STD850) was received on 3/01/23 from Sacramento Metropolitan Fire Department and the home has been cleared for up to 14 children on first floor only.


LPA discussed ratios for a large capacity and personnel records. Licensee understands that her own children under the age of 10 count towards the total ratio and capacity. Licensee understands that when there is no assistant present, ratios of a small capacity must be adhered to. LPA provided a copy of CCR Regulation 102416.5 which discusses Ratio and Capacity. LPA discussed required documentation for adult and minor assistants.

Licensee 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 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. REPORT CONTINUED ON THE FOLLOWING PAGE.
SUPERVISORS NAME: Natalie Dunaway
LICENSING EVALUATOR NAME: Soleil Marx
LICENSING EVALUATOR SIGNATURE: DATE: 03/06/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/06/2023
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
RIVER CITY (SACTO)CC, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833
FACILITY NAME: MOVSISYAN, HASMIK
FACILITY NUMBER: 343624714
VISIT DATE: 03/06/2023
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In the areas that were evaluated, no deficiencies were observed.

Licensee will submit documentation of stairs properly barricaded and placement of required postings to LPA Marx by today, 03/06/2023. Pending receival of documentation, Licensee’s request for a Large Family Child Care License is approved. Once approved, Licensee will be able to provide care for 12 children (when there is an assistant present) with no more than 4 infants or capacity of 14 children when 1 child in kindergarten or elementary school and 1 child at least age 6 and a maximum of 3 infants. Infants are children under the age of two years.

Licensee was encouraged to visit the Department website at WWW.CCLD.CA.GOV for childcare updates, current forms, legislation and regulation information. This facility evaluation report was reviewed and discussed with the licensee.

An exit Interview was conducted and a Notice of Site Visit was provided, which should remain posted for 30 days for parental review.
SUPERVISORS NAME: Natalie Dunaway
LICENSING EVALUATOR NAME: Soleil Marx
LICENSING EVALUATOR SIGNATURE:

DATE: 03/06/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/06/2023
LIC809 (FAS) - (06/04)
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