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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384001557
Report Date: 05/10/2024
Date Signed: 05/10/2024 04:21:27 PM

Document Has Been Signed on 05/10/2024 04:21 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
SAN BRUNO CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME:MELIKYAN, GAYANEFACILITY NUMBER:
384001557
ADMINISTRATOR/
DIRECTOR:		MELIKYAN, GAYANEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(415) 672-4935
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94116
CAPACITY: 14TOTAL ENROLLED CHILDREN: 12CENSUS: 9DATE:
05/10/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:00 PM
MET WITH:Gayana MelikyanTIME VISIT/
INSPECTION COMPLETED:
04:30 PM
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On May 10, 2024, Licensing Program Analysts (LPAs) Basak and Van conducted a random annual inspection and met the Licensee, Gayane Melikyan. LPAs explained the purpose of the inspection to the Licensee, and LPAs were granted entry to the home. Upon entering the house, LPAs observed the licensee and three helpers supervising 9 children (8 preschool-age and 1 infant). The licensee complies with the licensing capacity and limits today.

All adults present during the inspection have had criminal clearance verified by the CDSS Guardian System. According to the licensee, there are no changes to the previously approved childcare and off-limit areas.

The Daycare area is on the ground level, including the playroom, nap room, bathroom, and backyard. The entire second floor and the garage are off-limit to children. Days and operation hours are Monday - Friday from 8:00 am – 6:00 pm. Per Licensee, when a child shows signs of illness, the Licensee will separate and have the child waiting in the nap room while contacting the parent to pick up.

LPAs and the Licensee toured the childcare areas for health and safety hazards. The childcare area is clean and organized, with age-appropriate toys and equipment. The house has sufficient lighting and ventilation. A functional telephone, multiple working smokes and carbon monoxide detectors, and a fully charged 2A10BC fire extinguisher are all in the house. LPAs observed several cribs and highchairs at the facility. LPAs reminded the Licensee that highchairs are used only when children are eating/feeding.
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SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Zeynep Basak
LICENSING EVALUATOR SIGNATURE: DATE: 05/10/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/10/2024
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BRUNO CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: MELIKYAN, GAYANE
FACILITY NUMBER: 384001557
VISIT DATE: 05/10/2024
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LPAs did not observe any toys or pillows inside and no objects hanging above the cribs. LPAs discussed with the Licensee that all mattresses/padding should be designed for the particular cribs/play yards, and bedsheets should be tight-fitted. In addition, the Licensee was informed to check on the infant every 15 minutes during naptime physically. The Licensee understood that no baby walkers, bouncers, exersaucers, or other similar items are permissible to be used during daycare hours. According to the Licensee, there are no bodies of water on the premises. Daycare children have no access to detergents, disinfectants, or cleaning chemicals. The Licensee stated there are no guns or weapons in the house.

The Licensee and her helpers have valid CPR & First Aid certifications and Mandated Reporter training. Per Licensee, the fire and earthquake drills are conducted at least once every six months, with the latest drills conducted on 2/18/2024. The children's roster has been reviewed and found to be complete and up to date.

Children's files were reviewed. The Licensee maintains thorough records for all children in their care, including vaccination records and Parental Rights forms. LPAs noted that each kid had a complete emergency card with the child's full name, phone number, and the location of a parent or authorized person who may be called in an emergency. There is no transportation provided. Capacity options were reviewed, and the Licensee acknowledges that care cannot be provided over the capacity specified on the license.

The requirements for reporting suspected child abuse, as well as reporting requirements for unusual incidents, were discussed. All mandatory postings are posted (License/Parent's Rights poster/Emergency Disaster Plan and Earthquake Preparedness Checklist).

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. 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.
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SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Zeynep Basak
LICENSING EVALUATOR SIGNATURE:

DATE: 05/10/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/10/2024
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
SAN BRUNO CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: MELIKYAN, GAYANE
FACILITY NUMBER: 384001557
VISIT DATE: 05/10/2024
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LPAs discussed the safe sleep regulations with the licensee and discussed the Child Care Licensing Safe Sleep webpage https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed the 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 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: www.ada.gov/childqanda.htm.

Licensee was reminded about the Provider Information Notices (PINs) on the CCLD website. Licensee was informed that as of September 1, 2016, a person may not be employed or volunteer at a childcare facility unless he or she has been immunized against influenza, pertussis, and measles or qualifies for an exemption pursuant to Health and Safety code 1596.7995 and 1597.662.

LPAs reviewed AB 1207 with the Licensees. As of January 1, 2018, all staff must complete Mandated Reporter Training every two years. The training can be obtained online at www.mandatedreporterca.com.

Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain childcare by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California.
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SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Zeynep Basak
LICENSING EVALUATOR SIGNATURE:

DATE: 05/10/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/10/2024
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
SAN BRUNO CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: MELIKYAN, GAYANE
FACILITY NUMBER: 384001557
VISIT DATE: 05/10/2024
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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.

During the exit interview, the LICENSEE, GAYANE MELIKYAN, confirmed that there are no Registered Sex Offenders living in the facility, and LPAs completed the RSO profile in FAS.

A notice of site visit was given and must remain posted for 30 days.

An exit interview was conducted, and the report and appeal rights were reviewed with the licensee, Gayane Melikyan.
SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Zeynep Basak
LICENSING EVALUATOR SIGNATURE:

DATE: 05/10/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/10/2024
LIC809 (FAS) - (06/04)
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