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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191600232
Report Date: 06/20/2023
Date Signed: 06/20/2023 02:49:04 PM


Document Has Been Signed on 06/20/2023 02:49 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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245



FACILITY NAME:FIRST UNITED METHODIST CHURCH PRESCHOOLFACILITY NUMBER:
191600232
ADMINISTRATOR:BATSHEVA SPECTORFACILITY TYPE:
850
ADDRESS:1008 11TH STREETTELEPHONE:
(310) 395-7292
CITY:SANTA MONICASTATE: CAZIP CODE:
90403
CAPACITY:128CENSUS: DATE:
06/20/2023
TYPE OF VISIT:OfficeUNANNOUNCEDTIME BEGAN:
02:37 PM
MET WITH:TIME COMPLETED:
02:48 PM
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On 6/20/2023 Licensing Program Analyst met with Erika De Los Santos for the purpose of amending page 1 of the licensing report that was created on 5/3/2023. The licensing report reads the outdoor activity space to be 4275.61 for a total of 58 children, the correct measurement should read 4375.61 for a total of 58 children.

This report was discussed with Erika De Los Santos and a copy was provided.

SUPERVISOR'S NAME: Claudia EscobedoTELEPHONE: (424) 301-3044
LICENSING EVALUATOR NAME: Jillinda ChandlerTELEPHONE: (424) 301-3068
LICENSING EVALUATOR SIGNATURE:
DATE: 06/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/20/2023
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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