198019889-2-27-2023-33-CC-AEIN-CPFU2Z-20230227141247

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198019889
Report Date: 02/27/2023
Date Signed: 02/27/2023 02:12:58 PM

Document Has Been Signed on 02/27/2023 02:12 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:	SHAHVERDYAN FAMILY CHILD CARE		FACILITY NUMBER:	198019889
ADMINISTRATOR:	TAMAR SHAHVERDYAN		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(818) 207-7709
CITY:	GLENDALE	STATE: CA	ZIP CODE:	91204
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS: 10	DATE:	02/27/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	12:00 PM
MET WITH:	Tamar Shahverdyan, Licensee		TIME COMPLETED:	02:30 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	REQUIRED- 1 YEAR INSPECTION CONDUCTED IN ARMENIAN Licensing Program Analysts (LPA) Anomeh Eivazian Mary Silva conducted an unannounced required 1- year inspection to the above facility on 02/27/2023. LPAs arrived at the facility at 12:00 PM and met with Tamar Shahverdyan, Licensee who guided analysts on a tour of the facility. A COVID 19 risk assessment was conducted prior to entering the facility. Also present during this inspection, was Araks Avetyan, Licensee’s Assistant. Per licensee, Tamar Shahverdyan facility hours are Monday to Saturday from 6:30 a.m. to 8:30 p.m. LPAs provided a copy of Entrance Checklist—Family Child Care Home (LIC126) to licensee. All areas identified on the facility sketch were inspected. This is a one story home located on the first level. The home consists of 4 bedrooms, 2 restrooms, living room (FIREPLACE: which is inaccessible), dining room, kitchen, laundry room, garage, front yard, and backyard (fenced). The children use the bathroom in the hallway of kitchen, 1 bedroom (day care room) which has access from back yard, 1 bedroom which is located between the kitchen and bathroom, and backyard (fenced). Parents enter the home through the side gate which has access to the day care room. Per licensee, areas off limits to children and parents include: Living room, dining room, kitchen, 2 bedrooms, 1 bathroom, laundry room, front yard, and garage. 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 12:10 p.m., Licensee took this LPAs on a tour of the home. LPAs were toured through the interior starting with the two daycare room (daycare classrooms), LPAs observed children's table, chairs, and toys in the daycare rooms. LPAs observed 10 children were present in the daycare area with licensee and her assistant. LPA observed all electrical outlets were covered in daycare rooms. Next LPA toured the bathroom and did not observed any hazards. LPAs observed a safety gate was installed to the kitchen to make the rest of the home (off-limit areas) 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: 02/27/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/27/2023

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: SHAHVERDYAN FAMILY CHILD CARE	FACILITY NUMBER: 198019889
	VISIT DATE: 02/27/2023

NARRATIVE

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LPAs observed the required 2A 10BC fire extinguisher was anchored to the wall in the laundry room. It was serviced on 08/01/2021 as read by LPA from the service tag. Licensee tested the carbon monoxide and smoke detectors in the kitchen. It 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. 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.

Next LPAs toured the backyard fenced. Currently, children are using the back yard for outdoor play time. The outdoor play area was observed to be fenced. LPA observed that the outdoor yard has toys and other materials for children to play with. LPAs 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, Tamar Shahverdyan at 12:30 p.m. there are no pets, pools, spas, hot tubs, fish ponds, or similar bodies of water on the premises. LPAs observed swords collection in the living room, which is in a closed glass storage and locked with a key lock.

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 10 children with licensee and her assistant. All adults present have obtained a criminal record clearance on Licensing Information System (LIS). Per licensee, Tamar Shaverdyan 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 10/01/2023. Licensee, Tamar Shahverdyan completed required mandated reporter training on 06/21/2021. There are first aid supplies available on the premises in the laundry room. LPAs advised licensee that if a child shows signs of illness he/she/they shall be separated from other children.

REPORT CONTINUES ON NEXT PAGE 2 of 4

SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Anomeh Eivazian
LICENSING EVALUATOR SIGNATURE:	DATE: 02/27/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/27/2023

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: SHAHVERDYAN FAMILY CHILD CARE	FACILITY NUMBER: 198019889
	VISIT DATE: 02/27/2023

NARRATIVE

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At 1:00 p.m., facility roster was reviewed and completed. Per licensee currently there are 14 children enrolled. LPAs reviewed 6 children's records, including emergency information from 14 enrolled children, and all 6 reviewed files were completed.

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 02/2023. Emergency Disaster Plan, Parent’s Rights Poster and the facility License were observed to be posted at the wall in the daycare room.

LPAs 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 in accordance with standard established by Family Child Care statue.

INFANT CARE: Licensee states that currently she does not have any infants enrolled in her daycare. Per licensee, if an infant is enrolled, the infant will sleep in the daycare areas 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 covered with 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. 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. 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: 02/27/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/27/2023

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: SHAHVERDYAN FAMILY CHILD CARE	FACILITY NUMBER: 198019889
	VISIT DATE: 02/27/2023

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.
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 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, Tamar Shahverdyan at 2:30 p.m..

REPORT END 4 of 4

SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Anomeh Eivazian
LICENSING EVALUATOR SIGNATURE:	DATE: 02/27/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/27/2023

LIC809 (FAS) - (06/04)

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