198017252-2-10-2022-33-CC-AEIN-CBHU6S-20220210141848

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198017252
Report Date: 02/10/2022
Date Signed: 02/10/2022 02:18:56 PM

Document Has Been Signed on 02/10/2022 02:18 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, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME:	MIKAELYAN FAMILLY CHILD CARE		FACILITY NUMBER:	198017252
ADMINISTRATOR:	MIKAELYAN, ZARINE		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(818) 956-9531
CITY:	GLENDALE	STATE: CA	ZIP CODE:	91205
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 12	CENSUS: 9	DATE:	02/10/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	12:30 PM
MET WITH:	Zarine Mikaelyan, Licensee		TIME COMPLETED:	02:40 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/REQUIRED INSPECTION CONDUCTED IN ARMENIAN Licensing Program Analysts (LPA) Anomeh Eivazian and David Kurdoglyan conducted an unannounced annual and required inspection to the above facility on 02/10/2022. Licensee was placed on required inspections for two years on 11/12/2019. LPAs arrived at the facility at 12:30 PM and met with Zarine Mikaelyan, Licensee who guided analyst on a tour of the facility. Also present during this inspection, was Armine Sarukhanyan, Licensee’s Assistant. Per licensee, facility hours are Monday to Friday from 7:00 a.m. to 11:00 p.m. This is a one story home which consists of 2 bedrooms, 1 bathroom, kitchen, living room (FIREPLACE: which is inaccessible and disconnected), and front yard (fenced). The children use the bathroom in the hallway, living room (activity room), one bedroom (nap room), front yard and fenced balcony . There is a screen door with (2) locks on the front entrance. Per licensee, areas off limits to children and parents include: licensee's bedroom and kitchen. LPA did not observe any 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. All areas identified on the facility sketch that are accessible for children to use were inspected for safety, comfort, and cleanliness. At 12:40 p.m., Licensee took this LPAs on a tour of the home. LPAs was toured through the interior starting with the living room (daycare classroom), LPAs observed sofas, a coffee table, a TV , children's table, chairs and toys in the living room. Next LPAs toured the one daycare bedroom and observed 8 children napping in the daycare bedroom with licensee's assistant. Next LPAs toured the one bathroom in the hallway and observed child proof safety latches on the cabinets where licensee stores cleaning compounds. Next LPAs toured the one off-limit bedroom and observed licensee's biological children doing zoom classes. LPAs observed a safety gate was installed to the kitchen to make it inaccessible to the children. REPORT CONTINUES ON NEXT PAGE 1 of 4

SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Anomeh Eivazian
LICENSING EVALUATOR SIGNATURE:	DATE: 02/10/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/10/2022

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

FACILITY NAME: MIKAELYAN FAMILLY CHILD CARE	FACILITY NUMBER: 198017252
	VISIT DATE: 02/10/2022

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LPAs observed the required 2A 10BC fire extinguisher was anchored to the wall by the entrance. It was serviced on 01/10/2022 as read by LPA from the service tag. Licensee tested the carbon monoxide and smoke detectors in the living room. Both sounded off the alarms and heard by LPAs 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 LPAs toured the front yard fenced. Currently, children are using the front yard for outdoor play time. The outdoor play area was observed to be fenced. LPAs observed that the outdoor yard has toys, swings and other materials for children to play with. LPA did not observe any objects that can pose a danger to children on the outdoor yard. The front yard ground is covered with artificial grass. The licensee states that supervision is always provided.

Per Licensee, at 1:10 p.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 there were 9 children present in the facility with licensee and her assistant. 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 Pediatric First Aid and CPR expires on 05/2022. Licensee, Zarine Mikaelyan completed required mandated reporter training on 01/29/2022. There are first aid supplies available on the premises in the living room. LPA advised licensee that if a child shows signs of illness he/she/they shall be separated from other children.
At 1:10 p.m., facility roster was reviewed and completed. Per licensee currently there are 12 children enrolled. LPAs reviewed 12 children's records, including emergency information from 12 enrolled children, and all 12 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: 02/10/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/10/2022

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: MIKAELYAN FAMILLY CHILD CARE	FACILITY NUMBER: 198017252
	VISIT DATE: 02/10/2022

NARRATIVE

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The licensee and her assistant 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 02/01/2022.

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 12 reviewed files.

INFANT CARE: Licensee states that she is currently caring for infants. Licensee states that infants sleep in the daycare one bedroom and living room where they are constantly supervised. Appropriate sleeping arrangements and cribs were observed. (one crib for each infant in care was observed). Cribs or play yard did not hinder the entrance or exit from the sleeping space, mattresses shall be firm and covered with a fitted sheet that overlaps the underside so it cannot be dislodged. Cribs and play yards were observed to be free of loose articles and objects. No objects were observed to be hanging above or attached to the side of the crib. LPAs did not observe any infants swaddled while in care. LPAs 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. LPAs provided the licensee with a copy of A Child Care Provider’s Guide to Safe Sleep, by American Academy of Pediatrics. LPAs 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: 02/10/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/10/2022

LIC809 (FAS) - (06/04)

Page: 3 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: MIKAELYAN FAMILLY CHILD CARE	FACILITY NUMBER: 198017252
	VISIT DATE: 02/10/2022

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SAFE SLEEP: LPAs 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.
LPAs advised the licensee to access forms, regulations and quarterly updates online at: www.ccld.ca.gov.
LPAs 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. Licensee, children above two years old, and staff wear masks all the times indoor and teaching children about wearing proper face covering.
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. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
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, Zarine Mikaelyan at 2:40 p.m..

REPORT END 4 of 4

SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Anomeh Eivazian
LICENSING EVALUATOR SIGNATURE:	DATE: 02/10/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/10/2022

LIC809 (FAS) - (06/04)

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