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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198021086
Report Date: 12/01/2023
Date Signed: 12/01/2023 11:29:19 AM

Document Has Been Signed on 12/01/2023 11:29 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:MANUKYAN FAMILY CHILD CAREFACILITY NUMBER:
198021086
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 7DATE:
12/01/2023
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Nara Manukyan, LicenseeTIME COMPLETED:
11:45 AM
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CASE MANAGEMENT INSPECTION CONDUCTED IN ARMENIAN
Licensing Program Analyst (LPA) Anomeh Eivazian conducted an unannounced case- management inspection to the above facility on 12/01/2023 due to licensee in requesting capacity increase. LPA arrived at the facility at 8:30 AM and met with Nara Manukyan, Licensee who guided analyst on a tour of the facility. A COVID 19 risk assessment was conducted prior to entering the facility. Also present during this inspection, were Anna Hovhannisyan and Roza Gyseinova, Licensee’s Assistant. Per licensee, Nara Manukyan facility hours are Monday to Friday from 7:30 a.m. to 5:30 p.m. Fire clearance for large family child care home was granted on 10/25/23.

This is a one story home located on the first level. The home consists of 3 bedrooms, 2 restrooms, living room, dining room, kitchen, front yard and backyard (fenced). Per licensee children use the bathroom adjacent to the kitchen, living room, two bedrooms and backyard (fenced). Per licensee areas off limits to children and parents include: Dining room, kitchen, one bedroom, one bathroom in the hallway of bedrooms and front yard. LPA did not observe stairs in the home. During this inspection individuals who reside in the home were discussed and notes on Confidential Name List (LIC811) and attached to this report. Per licensee, parents use the main entrance door, which leads to the living room to enter the facility.

All areas identified on the facility sketch that are accessible for children to use were inspected for safety, comfort, and cleanliness. At 8:45 a.m., the licensee began touring LPA’s through the home starting with the entry way which lead directly to the living room. The living room was inspected and electrical outlets were covered. LPA observed 7 children were present in the home, one being 6 years old, having breakfast in the living room with licensee and her two assistants. LPA observed children toys, tables and chairs in the living room. Next LPA toured the off-limit dining room and observed a sofa, a dining table and chairs in the dining room. LPA observed a safety gate was installed to the dining room to make the dining room inaccessible to the children. Next LPA toured the off-limit kitchen and did not observe any hazards. LPA observed a safety gate was installed to the kitchen to make the kitchen inaccessible to the children. Next LPA toured the
REPORT CONTINUES ON NEXT PAGE 1 of 4
SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Anomeh Eivazian
LICENSING EVALUATOR SIGNATURE: DATE: 12/01/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/01/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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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: MANUKYAN FAMILY CHILD CARE
FACILITY NUMBER: 198021086
VISIT DATE: 12/01/2023
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bathroom adjacent to the kitchen and did not observe any hazards. Next LPA toured the one daycare bedroom and observed children napping cots. During this inspection licensee added one off-limit bedroom as daycare area. Next LPA toured the second bedroom and did not observed any hazards. Per licensee, she will use the bedroom in the hallway mainly for napping only. LPA observed a safety gate was installed in the hallway of bedrooms to make off-limit bathroom and one bedroom inaccessible to the children. LPA observed licensee's family members personal belongings in the home. Per licensee no poisons are kept in the home. During this inspection 2A 10BC fire extinguisher was anchored to the wall in the dining room. It was serviced on 12/01/23 as read by LPA from the service tag. Licensee tested the carbon monoxide and smoke detectors in the living room. It sounded off the alarms and heard by LPA to be functional. Detergents, cleaning compounds, medications, and other items which could pose a danger to children were observed to be inaccessible to children.

Next LPA toured the backyard fenced. Per licensee, children use the back yard for outdoor play time. The outdoor play area was observed to be fenced. LPA observed that the outdoor yard has toys, swing, slide and other materials for children to play with. AC unit in the backyard was observed to be screened to prevent access. LPA did not observe any objects that can pose a danger to children on the outdoor yard. The licensee states that supervision is always provided. Per licensee, the side gate in the backyard is locked all the times.

Per licensee, she provides food for children in care. Licensee was advised that if food is brought from the children’s homes, all containers must be labeled with child’s name and properly stored or refrigerated. Per Licensee, Nara Manukyan at 10:13 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 7 children were present in the home, one being an infant and one 6 years old with licensee and her two assistants. All adults present have obtained a criminal record clearance on Licensing Information System (LIS). Per licensee, Nara Manulyan currently she has two assistants. 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.
REPORT CONTINUES ON NEXT PAGE 2 of 4
SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Anomeh Eivazian
LICENSING EVALUATOR SIGNATURE:

DATE: 12/01/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/01/2023
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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: MANUKYAN FAMILY CHILD CARE
FACILITY NUMBER: 198021086
VISIT DATE: 12/01/2023
NARRATIVE
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The licensee and other personnel have completed training on preventive health practices including Pediatric First Aid and CPR. The licensee's Pediatric First Aid and CPR expires on 05/24. Licensee, Nara Manukyan completed required mandated reporter training on 08/08/22. There are first aid supplies available on the premises in the kitchen. LPA advised licensee that if a child shows signs of illness he/she/they shall be separated from other children.

At 10:50 a.m., facility roster was not available for review. Per licensee currently there are 8 children enrolled. LPA reviewed 8 children's records, including emergency information from 8 enrolled children, and all 8 reviewed files were completed. The licensee has proof of immunization against influenza, pertussis, and measles. Licensee's two assistants did not have proof of immunization against Measles, (MMR), Pertussis (TDAP) and Influenza on file.

All homes shall conduct fire and disaster drills at least once every six months, and document the date and time of each drill. Per licensee, she has not conduct a fire drill with children. 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 cellphone that is used and the cellphone stays at the facility during operation hours. Per licensee she carries liability insurance or a bond in accordance with standard established by Family Child Care statue.

INFANT CARE: Licensee states that currently she has one infant enrolled in her daycare who is 19 months old. Licensee states that the infant sleep in the living room and two daycare bedrooms where they are constantly supervised. Appropriate sleeping arrangements and cribs were observed. 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: 12/01/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/01/2023
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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: MANUKYAN FAMILY CHILD CARE
FACILITY NUMBER: 198021086
VISIT DATE: 12/01/2023
NARRATIVE
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SAFE SLEEP: LPA discussed the safe sleep regulations with licensee, 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. Boppy recall: https://www.cpsc.gov/Recalls/2021/The-Boppy-Company-Recalls-Over-3-Million-Original-Newborn-Loungers-Boppy-Preferred-Newborn-Loungers-and-Pottery-Barn-Kids-Boppy-Newborn-Loungers-After-8-Infant-Deaths-Suffocation-Risk

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. 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.

The following deficiencies listed on the attached LIC 809 (deficiency page) are being cited in accordance with California Code of Regulations Title 22. Deficiencies that are being cited need to be cleared to protect the children’s health & safety.

The Notice of Site Visit (LIC 9213) was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with the Licensee, Nara Manulyan at 11:45 a.m..


REPORT END 4 of 4
SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Anomeh Eivazian
LICENSING EVALUATOR SIGNATURE:

DATE: 12/01/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/01/2023
LIC809 (FAS) - (06/04)
Page: 4 of 6
Document Has Been Signed on 12/01/2023 11:29 AM - It Cannot Be Edited


Created By: Anomeh Eivazian On 12/01/2023 at 10:43 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: MANUKYAN FAMILY CHILD CARE
FACILITY NUMBER: 198021086

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/01/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
12/08/2023
Section Cited
CCR
102417(g)(8)

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Operation of Family Child Care Home
Each family child care home shall have a current roster of children as specified in Health and Safety Code Section 1596.841.
This requirement was not met as evidenced by...
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Per licensee, she will have her facility current roster by 12/08/23 and a copy will be submitted to LPA via email.
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During this inspection facility roster was not availalbe for review.

This poses a potential health , safety and personal right risk to the children in care.
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Type B
12/08/2023
Section Cited
CCR102417(g)(9)(A)

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Operation of Family Child Care Home
Each family child care home shall conduct fire drills and disaster drills at least once every six months.
This requirment was not met as evidenced by...
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Per licensee, she will conduct a fire drill with daycare children by 12/08/23, and a copy of fire drill log will be submitted to LPA via email.
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Per licensee, she has not conducted a fire drill with her daycare children yet.

This poses a potential health, safety and personal right risk to the children in care.
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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:Christina Gabelman
LICENSING EVALUATOR NAME:Anomeh Eivazian
LICENSING EVALUATOR SIGNATURE:
DATE: 12/01/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/01/2023


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Document Has Been Signed on 12/01/2023 11:29 AM - It Cannot Be Edited


Created By: Anomeh Eivazian On 12/01/2023 at 10:55 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: MANUKYAN FAMILY CHILD CARE
FACILITY NUMBER: 198021086

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/01/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
12/08/2023
Section Cited
HSC
1597.622(a)(1)

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(1) Commencing September 1, 2016, a person shall not be employed or volunteer at a family day care home if he or she has not been immunized against influenza, pertussis, and measles. etc...

This requirement is not met as evidenced by:
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Per licensee, her two assistants will have proof of immunization against Measles, Pertussis and Influenza by 12/08/23 and copies will be submitted to LPA via email.
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During this inspection licensee's two assistants did not have proof of immunization against Measles (MMR), Pertussis (TDAP) and influenza on file.
This poses a potential health, safety and personal right risk to the children in care.
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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:Christina Gabelman
LICENSING EVALUATOR NAME:Anomeh Eivazian
LICENSING EVALUATOR SIGNATURE:
DATE: 12/01/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/01/2023


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