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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191603677
Report Date: 02/03/2022
Date Signed: 02/03/2022 12:56:14 PM


Document Has Been Signed on 02/03/2022 12:56 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:HOLY TRINITY LUTHERAN CHILD CARE CENTERFACILITY NUMBER:
191603677
ADMINISTRATOR:KORY HIGGINSFACILITY TYPE:
850
ADDRESS:9300 CRENSHAW BLVDTELEPHONE:
(323) 757-4850
CITY:INGLEWOODSTATE: CAZIP CODE:
90305
CAPACITY:85CENSUS: 28DATE:
02/03/2022
TYPE OF VISIT:Case Management - Annual ContinuationUNANNOUNCEDTIME BEGAN:
12:42 PM
MET WITH:Kory Higgins, DirectorTIME COMPLETED:
01:15 PM
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On 02/03/2022 Licensing Program Analyst continued the 1 year required inspection started on 01/28/2022. During inspection LPA observed 28 children files in care for completeness and Toddlers Safe Sleep Document regarding the 15min check during nap time. LPA completed Staff Interview with Kory Higgins, Director. LPA also cleared all Plan of Corrections during inspection.


Exit interview was conducted with Kory Higgins, Director.
SUPERVISOR'S NAME: Karren StarksTELEPHONE: (424) -30-3038
LICENSING EVALUATOR NAME: Shandra PowellTELEPHONE: (424) 301-3053
LICENSING EVALUATOR SIGNATURE:
DATE: 02/03/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/03/2022
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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