198018049-12-3-2021-33-CC-NTCG-C9CQWH-20211203113158

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198018049
Report Date: 12/03/2021
Date Signed: 12/03/2021 11:32:07 AM

Document Has Been Signed on 12/03/2021 11:32 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:	KERMEZIAN FAMILY CHILD CARE		FACILITY NUMBER:	198018049
ADMINISTRATOR:	KERMEZIAN, ALICE & LINA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(626) 639-3733
CITY:	PASADENA	STATE: CA	ZIP CODE:	91104
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 2	CENSUS: 2	DATE:	12/03/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:40 AM
MET WITH:	Lina Kermezian - Licensee		TIME COMPLETED:	11:47 AM

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	Licensing Program Analyst (LPA) Nolan Tcheng conducted an unannounced required annual random inspection to the above facility. At 9:40am, LPA met with licensee Lina Kermezian, to whom the purpose of the visit was explained. Also present during this inspection, is Alice Kermezian, co-licensee. The licensee states that she currently has 2 children enrolled. A children’s roster is available and is current. Licensee’s hours of operation are Monday - Friday 7am-6pm. This is a two-story home which consists of 3 bedrooms, 4 bathrooms, kitchen, breakfast room, living room (fireplace is made inaccessible), day care room, laundry room, detached garage, storage room, and backyard (fenced). The children use one bedroom, bathroom by laundry room leading to backyard, living room, kitchen, dining room area, day care area, and backyard. LPA observed the day care area to have padding and a gate surrounding it. Per licensee, areas off limits to children and parents include: 1 master bedroom , 1 bathroom by the entrance, garage, storage, second floor master bedroom and bathroom, and front yard. LPA observed a child gate making the stairs inaccessible to children in care. Adults residing in the home were noted on the attached LIC811. All individuals present in the home have obtained a criminal record clearance or exemption prior to working, residing or volunteering in a licensed home. There is a pool on the property. Pool fence was observed to be an iron gate that meets the Title 22 regulations for a body of water at a child care facility. LPA ensured the pool was made inaccessible to children in care. Gate was locked, has a latch at the top, and opens away from the pool. Pool is located behind storage and detached garage in the backyard. Per licensee, there are no weapons or firearms on the premises. PHYSICAL PLANT At 9:45am, LPA was lead on a tour of the facility by the licensee. REPORT CONTINUES PAGE 1 of 3

SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Nolan Tcheng
LICENSING EVALUATOR SIGNATURE:	DATE: 12/03/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/03/2021

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: KERMEZIAN FAMILY CHILD CARE	FACILITY NUMBER: 198018049
	VISIT DATE: 12/03/2021

NARRATIVE

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The tour began, near the front where licensee showed the current check in procedures they are utilizing due to COVID. LPA observed a pull down fire alarm by the front entrance. Tour continued through the living room area to the day care area. Fireplaces and open face heaters are inaccessible to prevent access by children. Emergency Disaster Plan, Parent’s Rights Poster and the Facility License are observed to be posted by the day care area. Smoke and carbon monoxide detectors were tested and are operable. LPA observed napping equipment in the form of cots. Equipment is stored in day care area. As LPA entered kitchen at 9:53am, a fire extinguisher was observed. The valve on the required 2A 10BC fire extinguisher indicates fully charged and was serviced on 08/28/2021, as indicated on service tag. Per State Fire Marshall standards, fire extinguishers shall be serviced annually. Sharp knives were observed to be kept in a high cabinet out of reach of children in care. Child safety latches were observed on the cabinets within reach of children. Detergents, cleaning compounds, medications, and other items which could pose a danger are 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. The licensee states that there is a land line on the premises. At 10:01am, LPAs observed the back yard area. The outdoor play area was observed to be fenced. At this time, children are using the back yard for outdoor play time. There are first aid supplies available. Per licensee, the bedroom or living room will be used as an area for an ill child until an authorized representative comes to pick up child. The licensee is observed to be operating within the license capacity limitations.

FACILITY RECORDS:
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 02/22/2022. Both licensees have complete mandated reporter training that expires on 02/10/2022. The licensee does have proof of immunization against influenza, tuberculosis, pertussis, and measles. Children’s records were reviewed, including but not limited to, a copy of the emergency information card that contains all the information specified by regulation. Last disaster drill observed to be logged 10/04/2021.

The following was discussed:
-Individuals who are 18 years of age or older living in the home must be finger print cleared prior to being in the presence of the children in care. Individuals within one month of their 18th birthday must be fingerprinted immediately.
-There are no pets on the premises. REPORT CONTINUES PAGE 2 of 3

SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Nolan Tcheng
LICENSING EVALUATOR SIGNATURE:	DATE: 12/03/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/03/2021

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: KERMEZIAN FAMILY CHILD CARE	FACILITY NUMBER: 198018049
	VISIT DATE: 12/03/2021

NARRATIVE

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-Infant Walkers, Johnny Jumpers, Saucer Chairs, Trampolines and/or any other item that falls into these categories are not permitted in a family child care facility.
-Smoking is prohibited in a license family child care home.

Infant Care: Licensee states that they are not currently caring for infants. LPA advised the licensee to sleep infants where they can be directly supervised at all times and advised the licensee against sleeping infants in a separate room. LPA provided the licensee with a copy of the Child Care Provider’s Guide to Safe Sleep, by American Academy of Pediatrics and Helping you to reduce the risk of SIDS. LPA consulted and explained Child Abuse Reporting, Updated Parent’s Rights Poster with Complaint Hotline information, Never Shake a Baby, Sudden Infant Death Syndrome (SIDS), and Safe Sleeping practices. PIN 20-24-CCP was provided and explained during the inspection.

Incidental Medical Services (IMS):
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.
During this inspection, LPA observed health and safety protocols for COVID-19 were being followed. Signs were placed around facility. Facemasks were observed to be worn at facility.

LPA advised the licensee how to access forms, regulations and quarterly updates on line at: www.ccld.ca.gov. AB1207 Mandated Child Abuse Reporting – Implementation was discussed with Licensee. Website provided: http://mandatedreporterca.com/
The Notice of Site Visit (LIC 9213) – must remain posted for 30 days during the hours of operation after each site visit made by a licensing representative.
At this time, the licensee is in compliance with California Code of Regulations Title 22. No deficiencies cited.
Exit interview was conducted with Lina Kermezian, at 11:30am, Licensee, and copy of report was provided.

REPORT ENDS PAGE 3 of 3

SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Nolan Tcheng
LICENSING EVALUATOR SIGNATURE:	DATE: 12/03/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/03/2021

LIC809 (FAS) - (06/04)

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