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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198207508
Report Date: 08/23/2022
Date Signed: 08/24/2022 12:09:18 PM


Document Has Been Signed on 08/24/2022 12:09 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
CCLD Regional Office, 300 N. CONTINENTAL BLVD. #290B
EL SEGUNDO, CA 90245



FACILITY NAME:UNITED CHILD CARE, INC.FACILITY NUMBER:
198207508
ADMINISTRATOR:SUMNER, LENA D.FACILITY TYPE:
730
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:6CENSUS: 0DATE:
08/23/2022
TYPE OF VISIT:Required - 2 YearUNANNOUNCEDTIME BEGAN:
11:40 AM
MET WITH:Hakop "Jack" Daldalyan-AdministratorTIME COMPLETED:
03:00 PM
NARRATIVE
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 On August 23, 2022 at 11:40 AM, Licensing Program Analyst (LPA) Donald Martin and LPM JoAunne Griffin made an unannounced visit to United Child Care, Inc. for the purpose of a Required 2 Year Inspection. LPA met with Hakop "Jack" Daldalyan, Administrator and toured the interior and exterior of the home. There are currently no children placed in the home. Home is currently not set-up to receive children. Currently, Mr. Daldalyan, Gayane Daldalyan (wife) and Hovsep Daldalyan (son) reside in the home.

The home is located in a residential area with 4 bedrooms, four bathrooms, two living rooms two dining rooms, two kitchens, laundry area and backyard. Bedroom #1 is utilized as an office with a desk and sofa. Bedroom #2 has two twin beds and sleeps Mrs. Daldalyan. Bedroom #3 has two twin beds and sleeps Mr. Daldalyan, Administrator. Bedroom #4 has two twin beds and sleeps Hovsep Daldalyan. There was adequate drawer and closet space in the bedrooms. All bathrooms were observed to be in working order.

The backyard has a two story apartment unit with two units. Both units are occupied. There is a washer and dryer on the side of the home. Under the upstairs unit is several stacked boxes of supplies used for construction. There was also a covered vehicle. Mr. Daldalyan stated that those supplies belong to the owner as well as the units.

Facility cited for violation of California Code of Regulations, Title 22 Division Six, regulation 80066 (e) Personnel Records, 84063(a)(9) and 84063 (a)(10) Accountability and 84072.2 (a) Complaint Procedures. During inspection Board Member meeting minutes were not retained at facility and not available upon request. Complaint reporting procedures were not posted during inspection.
SUPERVISOR'S NAME: JoAunne GriffinTELEPHONE: (310) 916-8782
LICENSING EVALUATOR NAME: Donald C MartinTELEPHONE: (424) 301-3026
LICENSING EVALUATOR SIGNATURE:
DATE: 08/23/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/23/2022
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 3


Document Has Been Signed on 08/24/2022 12:09 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 300 N. CONTINENTAL BLVD. #290B
EL SEGUNDO, CA 90245


FACILITY NAME: UNITED CHILD CARE, INC.
FACILITY NUMBER: 198207508

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/23/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
80066(e)
Personnel Records
(e) All personnel records shall be maintained at the facility site.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation the licensee did not comply with the section cited above and staff files were not available for review during inspection which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 09/07/2022
Plan of Correction
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Licensee is to submit proof that staff files are secured and maintained in facility by 09/07/2022.
Type B
Section Cited
CCR
84063(a)(9)
Accountability
(a) The board of directors shall be active in ensuring accountability, and shall perform, at a minimum, the following duties: (9) Ensure that minutes are kept for all board of directors meetings and retained as a permanent record. The minutes shall reflect the board's discussion of the documents specified in Health and Safety Code Section 1520.1(f);

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on interview the licensee did not comply with the section cited above in that meeting minutes were not retained as a permanent record which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 09/07/2022
Plan of Correction
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Licensee is to submit proof of last Board Members meeting, meeting notes by 09/07/2022.

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: JoAunne GriffinTELEPHONE: (310) 916-8782
LICENSING EVALUATOR NAME: Donald C MartinTELEPHONE: (424) 301-3026
LICENSING EVALUATOR SIGNATURE:
DATE: 08/23/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/23/2022
LIC809 (FAS) - (06/04)
Page: 2 of 3


Document Has Been Signed on 08/24/2022 12:09 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 300 N. CONTINENTAL BLVD. #290B
EL SEGUNDO, CA 90245


FACILITY NAME: UNITED CHILD CARE, INC.
FACILITY NUMBER: 198207508

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/23/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
84063(a)(10)
Accountability
(a) The board of directors shall be active in ensuring accountability, and shall perform, at a minimum, the following duties: (10) Ensure that all minutes of board of directors' meetings are available to the licensing agency to inspect, audit, and copy upon demand during normal business hours. Minutes may be removed if necessary for copying. Removal of minutes shall be subject to the following requirements:

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation and interview, the licensee did not comply with the section cited above in that meeting minutes were not available which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 09/07/2022
Plan of Correction
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Licensee is to submit plan to ensure that all meeting notes are received timely and available for inspection by 09/07/2022.
Type B
Section Cited
CCR
84072.2(a)
Complaint Procedures
(a) The licensee of a group home shall develop, maintain and implement written complaint procedures by which children or their authorized representatives are permitted to file complaints, without fear of retaliation, with the facility administrator regarding facility staff or operations.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above in [count] out of [total count] [(objects) (persons)] [identifiers] which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 09/07/2022
Plan of Correction
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Licensee is to submit proof that complaint reporting procedures are posted in facility by 09/07/2022.

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: JoAunne GriffinTELEPHONE: (310) 916-8782
LICENSING EVALUATOR NAME: Donald C MartinTELEPHONE: (424) 301-3026
LICENSING EVALUATOR SIGNATURE:
DATE: 08/23/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/23/2022
LIC809 (FAS) - (06/04)
Page: 3 of 3