198020428-9-27-2021-33-CC-AEIN-C79PWS-20210927114114

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198020428
Report Date: 09/27/2021
Date Signed: 09/27/2021 11:41:23 AM

Document Has Been Signed on 09/27/2021 11:41 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
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME:	HAKOBYAN FAMILY CHILD CARE		FACILITY NUMBER:	198020428
ADMINISTRATOR:	LILIT HAKOBYAN		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(818) 294-8916
CITY:	GLENDALE	STATE: CA	ZIP CODE:	91206
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 0	CENSUS: 2	DATE:	09/27/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	08:58 AM
MET WITH:	Lilit Hakobyan, Licensee		TIME COMPLETED:	12:00 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	ANNUAL INSPECTION CONDUCTED IN ARMENIAN Licensing Program Analyst (LPA) Anomeh Eivazian conducted an unannounced annual inspection to the above facility on 09/27/2021. LPA arrived at the facility at 8:45 0AM and met with Lilit Hakobyan, Licensee who guided analyst on a tour of the facility. Also present during this inspection, was Vigen Baghumyan, Licensee’s husband. Per licensee, facility hours are Monday to Friday from 7:00 a.m. to 10:00 p.m. This is a town house located on the first level. The home consists of 3 bedrooms, 2 and 1/2 restrooms, living room, dining room, kitchen, and balcony in the first floor. There is a decorative disconnected fireplace in the living room which has been blocked off to prevent access to children. Per licensee the children use the half bathroom in the first floor, living room, dining room and balcony. Per licensee areas off limits to children and parents include: Kitchen, entire second floor which consists of 3 bedrooms and two bathrooms. LPA observed a safety gate was installed to the stairs which leads to the second floor. During this inspection individuals who reside in the home were discussed and notes on Confidential Name List (LIC811) and attached to this report. There is no outdoor area for children to use on the apartment premises. The licensee states that she takes children to the Wilson Mini Park (1101 E. Wilson Ave., Glendale, CA 91206) for outdoor play time. Children will be physically and visually supervised at all times. A written declaration on file. At 9:05 a.m., Licensee took this LPA on a tour of the home, childcare areas. LPA was toured through the interior starting with the living room and dining room, LPA observed a safety gate was installed to the stairs which leads to the second floor, also a safety gate was installed to the kitchen to make it inaccessible to the children. LPA observed children tables, chairs and toys in the living room and dining room. LPA was toured through the half bathroom in the first floor and observed a safety latch on the cabinet under the sink. LPA toured the balcony and did not observe any hazards. LPA observed the balcony is coveted with 6 feet fencing and rolling shades from the fence to the ceiling. REPORT CONTINUES ON NEXT PAGE 1 of 4

SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Anomeh Eivazian
LICENSING EVALUATOR SIGNATURE:	DATE: 09/27/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/27/2021

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, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: HAKOBYAN FAMILY CHILD CARE	FACILITY NUMBER: 198020428
	VISIT DATE: 09/27/2021

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Per licensee parents enter through the gate which leads to the Verdugo Rd and it is only being used by licensee. Licensee showed LPA the fire extinguisher was purchased on 10/16/2020 as read by LPA from the receipt. LPA observed the required 2A 10BC fire extinguisher was anchored to the wall by the wall by the entrance and kitchen. Licensee also tested the carbon monoxide and smoke detectors in the hallway of entrance. Both sounded off the alarms and heard by LPA to be functional. Posting requirements were observed to be posted at the time of inspection by the entrance door in the living room. Detergents, cleaning compounds, medications, and other items which could pose a danger to children were observed to be inaccessible to children. The licensee states that there are no poisons in the home and understands that storage areas for poisons must be locked with a key or combination lock. There are first aid supplies available on the premises in the home in the kitchen. Per licensee, she provides transportation to children.

Per Licensee, Lilit Hakobyan at 9:30 a.m. there are no pets, weapons, firearms, pools, spas, hot tubs, fish ponds, or similar bodies of water on the premises.

The licensee was observed to be operating within the licensed capacity and is not exceeding the required limitations during this inspection. During this inspection two children were present in the home. All adults present have obtained a criminal record clearance on Licensing Information System (LIS). Per licensee, currently she has one assistant. 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.

The licensee and other personnel have completed training on preventive health practices including Pediatric First Aid and CPR. The licensee's and her husband's, Vigen Baghumyan Pediatric First Aid and CPR expires on 07/2023. Licensee, Lilit Hakobyan and her husband , Vigen Baghumyan completed required mandated reporter training on 07/24/2021. LPA advised licensee at 9:50 a.m. that if a child shows signs of illness he/she/they shall be separated from other children.

At 10:00 a.m., facility roster was reviewed and completed. Per licensee currently there are 16 children enrolled. LPA reviewed 10 children's records, including emergency information from 16 enrolled children, and all 10 reviewed files were completed.

REPORT CONTINUES ON NEXT PAGE 2 of 4

SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Anomeh Eivazian
LICENSING EVALUATOR SIGNATURE:	DATE: 09/27/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/27/2021

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, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: HAKOBYAN FAMILY CHILD CARE	FACILITY NUMBER: 198020428
	VISIT DATE: 09/27/2021

NARRATIVE

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The licensee and her husband have proof of immunization against influenza, pertussis, and measles.

All homes shall conduct fire and disaster drills at least once every six months, and document the date and time of each drill. Last drill documented was conducted on 09/22/2021.

Emergency Disaster Plan, Parent’s Rights Poster and the Facility License were observed to be posted at the wall by the entrance.

LPA did not observe the following items during the inspection: Infant Walkers, Johnny Jumpers, Saucer Chairs, Trampolines and/or any other item that fall into these categories are not permitted in a family child care facility.

Smoking is prohibited in a licensed Family Child Care Home. Per Licensee, no one smokes in the home. There is telephone service via a landline stays at the facility during operation hours.
Per licensee she does not carry liability insurance or a bond in accordance with standard established by Family Child Care statue. Signed statements (LIC282) on 10 reviewed files.

INFANT CARE: Licensee states that she is caring for infants. Currently enrolled two infants are part-timers and do not sleep in the facility. Licensee states that if an infant is enrolled full time, the infant will sleep in the daycare area (living room and dining room) where they are constantly supervised. Appropriate sleeping arrangements and cribs will be available. (one crib for each infant in care is required). Cribs or play yard shall not hinder the entrance or exit from the sleeping space, mattresses shall be firm and shall be a fitted sheet that overlaps the underside so it cannot be dislodged. Cribs and play yards shall be free of loose articles and objects. No objects shall be hanging above or attached to the side of the crib. LPA did not observe any infants swaddled while in care. LPA advised the Licensee that infants shall be placed on their backs for sleeping and shall be supervised. Infants shall be checked on every 15 minutes and the time of each 15-minute check shall be documented with child’s name and date. The LIC 9227 Individual Infant Sleeping Plan shall be completed for each infant up to 12 months of age. A copy of the LIC 9227 was provided to Licensee. LPA provided the licensee with a copy of A Child Care Provider’s Guide to Safe Sleep, by American Academy of Pediatrics. LPA also consulted and explained Child Abuse Reporting, Never Shake a Baby, and Safe Sleeping practices.

REPORT CONTINUES ON NEXT PAGE 3 of 4

SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Anomeh Eivazian
LICENSING EVALUATOR SIGNATURE:	DATE: 09/27/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/27/2021

LIC809 (FAS) - (06/04)

Page: 2 of 4

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: HAKOBYAN FAMILY CHILD CARE	FACILITY NUMBER: 198020428
	VISIT DATE: 09/27/2021

NARRATIVE

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SAFE SLEEP: LPA discussed the safe sleep regulations with licensee, Lilit Hakobyan at 10:30 a.m. and discussed the Child Care Licensing Safe Sleep webpage at http://www.cdss.ca.gov/inforescources/child-care-licensing/public-information-and-resoucrces/safe-sleep as an additional resource. LPA also informed licensee of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at http://www/cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.
Medication: Incidental Medical Services (IMS) policy was discussed. The licensee states that she will provide IMS. Per licensee, there are no children enrolled that require IMS at this time. 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: http://www.ada.gov/childqanda.htm.

LPA advised the licensee to access forms, regulations and quarterly updates online at: www.ccld.ca.gov. LPA also discussed the Provider Information Notices (PINS) on Safe Sleep Awareness: PIN 19-02-CCP,
U.S. CONSUMER PRODUCT SAFETY COMMISSION FISHER-PRICE INFANT EQUIPMENT RECALLS: PIN 20-19 CCP COVID FAQ - PIN 20-11-CCP, Required Lead Testing: PIN 20-01 CCP Effects of Lead Exposure, and Guardian User Account Access - PIN 20-20-CCLD.

LPA inquired into the licensee’s practices related to COVID-19. Licensee stated that they practice hygiene such as hand washing with the children. Licensee has hand sanitizer available in the drop off area and inside her home. Licensee states they practice social distancing with children, take children temperature daily, licensee, staff and children wear masks all the times indoor.
At this time, the licensee is in compliance with California Title 22 Regulations. Therefore, there are no citations being issued today from the areas that were inspected today. The Notice of Site Visit (LIC 9213) was given and must remain posted for 30 days.
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 experienced. If you have any questions regarding the process or tools, please send them by email to [email protected]. For additional information regarding inspection tools and methods, please visit the Program website at www.cdss.gov/inforesouces/community-care-liceinsing/inspection-process Exit interview conducted and report was reviewed with the Licensee, Lilit Hakobyan at 12:00 p.m..

REPORT END 4 of 4

SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Anomeh Eivazian
LICENSING EVALUATOR SIGNATURE:	DATE: 09/27/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/27/2021

LIC809 (FAS) - (06/04)

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