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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197419262
Report Date: 06/30/2022
Date Signed: 06/30/2022 02:36:22 PM

Document Has Been Signed on 06/30/2022 02:36 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 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:DELKEOUKIAN FAMILY CHILD CAREFACILITY NUMBER:
197419262
ADMINISTRATOR:DELKEOUKIAN, ARBIFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(818) 426-4446
CITY:WINNETKASTATE: CAZIP CODE:
91306
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 14DATE:
06/30/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:05 PM
MET WITH:DELKEOUKIAN, ARBI- LicenseeTIME COMPLETED:
02:50 PM
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On 06/30/2022 Licensing Program Analyst (LPA), Suzette Ornelas conducted an unannounced Annual Required Inspection and was met by Licensee, Arbi Delkeoukian. Also present was Staff #1 (S1). Days and hours of operation are Monday through Friday 7a to 6p.

LPA toured the home inside and outside and a census was taken. LPA observed 14 children in care, 1 which is an infant over 12 months. The facility is a single story dwelling with 2 bedrooms, two bathrooms, living room, kitchen and step down family room. Childcare primarily being conducted in the family room. Children pass through the kitchen to get to the bathroom that is set up for their use with child size toilet and sink. Kitchen area was inspected for inaccessibility of toxins/cleaning compounds and other potentially dangerous objects/materials. LPA observed all sharps are inaccessible by use of safety latches and stove has knob covers for safety. The two bedrooms and the main bathroom are completely off limits. The backyard is completely fenced in. There are no bodies of water observed. There is a detached garage with access from the alley in the back. The garage is currently used for storage purposes and will be completely off limits to the children by a locked door.

Furniture and equipment were inspected for cleanliness, age appropriateness & good repair. Fire extinguisher (2A-10-BC) is mounted on the kitchen wall, not accessible to child care children and was serviced on 10/2021. The First Aid Kit is kept in the kitchen on top of the refrigerator. The licensee states there are no weapons at the facility. Back yard play area was inspected for safety, potential hazards. All poisons/pesticides are kept in a locked storage area in the detached locked garage.

Detergents, cleaning compounds, medication and other hazardous items are made inaccessible. There are no fireplaces or open face heaters in the home. There is a working, smoke detector, carbon monoxide detector tested by the licensee and adequate heating and ventilation for safety and comfort. The home has working telephone service and LPA confirmed the phone number is (818) 426-4446.
SUPERVISORS NAME: Lisa Rios
LICENSING EVALUATOR NAME: Suzette Ornelas
LICENSING EVALUATOR SIGNATURE: DATE: 06/30/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/30/2022
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
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: DELKEOUKIAN FAMILY CHILD CARE
FACILITY NUMBER: 197419262
VISIT DATE: 06/30/2022
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There is currently one infants in care. LPA discussed Safe Sleep Regulations with licensee. Infants are not swaddled while in care. Provider physically checks on sleeping infants every fifteen minutes and began documenting 15 minute checks and any signs of distress which includes but is not limited to flushed skin color, increase in body temperature, restlessness and labored breathing. Infants can be visually observed through an open door if sleeping in a separate room. LPA observed S1 sitting next to the infants during the entirety of nap time.

Licensee ensures that children in care are supervised at all times and is aware children shall not be left in parked vehicles. Car seats are used for transportation purposes only and are not used for sleeping children. The outdoor play area in the backyard is fenced and there are no hazards to children present. Capacity as specified on the license is being maintained.

LPA reviewed a sample of children’s files and observed files were complete with emergency information as required. Licensee’s Mandated Reporter Training as well as S1 were completed in 2022. Licensee’s pediatric CPR/First Aid expires on 2024. A review of records indicates that employees and/or volunteers do not have immunization records on file for influenza, pertussis and measles readily available to view. Licensee will submit physical proof of records to LPA via email. All adults who reside or work in the home have a criminal record clearance or exemption. There are no excluded individuals present at this home.

Incidental Medical Services (IMS) are not currently being provided. Licensee is aware that an IMS plan is required to be submitted to the licensing office if they provide any of these services. Information regarding Americans with Disability Act (ADA) can be obtained by contacting US Department of Justice toll free ADA Information line at (800) 514-0301(voice), (800) 514-0383 (TDD) and website link https://www.ada.gov/childqanda.htm.

LPA and Licensee discussed the Community Care Licensing website www.ccld.ca.gov which will provide access to Provider Information Notices (PINs), Quarterly Updates, COVID-19 Information and Resources, Mandated Reporter Training, Safe Sleep in Child Care, Lead Poisoning Facts, Forms and Regulations.
Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, no deficiencies are cited.
This report shall be made available to the public upon request. LIC 9213 Notice of Site Visit is provided and required to be posted for 30 days.
SUPERVISORS NAME: Lisa Rios
LICENSING EVALUATOR NAME: Suzette Ornelas
LICENSING EVALUATOR SIGNATURE:

DATE: 06/30/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/30/2022
LIC809 (FAS) - (06/04)
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