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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191890346
Report Date: 02/09/2024
Date Signed: 02/09/2024 04:48:58 PM


Document Has Been Signed on 02/09/2024 04:48 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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245



FACILITY NAME:HILLARY BROADOUS EARLY EDUCATION CENTERFACILITY NUMBER:
191890346
ADMINISTRATOR:MERMELL, RACHELFACILITY TYPE:
850
ADDRESS:11736 BROMONT AVE.TELEPHONE:
(818) 897-2009
CITY:PACOIMASTATE: CAZIP CODE:
91331
CAPACITY:118CENSUS: 36DATE:
02/09/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
02:10 PM
MET WITH:Jennifer Maddocks, PrincipalTIME COMPLETED:
05:00 PM
NARRATIVE
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Licensing Program Analysts (LPAs) Tatiana Bickham and Lilia Hernandez conducted an unannounced case management inspection to follow up on an incident that was reported to the department. LPAs arrived at the facility at 2:10PM and met with Sheila Hardy, Facility Representative/Principal, who guided LPA on a tour of the facility. LPAs was later met by Jennifer Maddocks, Principal. There were 36 children and 13 staff present upon arrival.

The incident that occurred on 01/17/2024, was reported to the Department on 01/17/2024, via telephone. The facility reported the Unusual Incident to the Department within the required 24 hours of occurrence.

Information reported to the Department indicated that child #1 personal rights may or may not have been violated.

LPAs conducted interviews and obtained documentation during this visit.

Based upon information received from the interviews conducted it was determined that the personal rights of child #1 were not violated.

There were no deficiencies cited during today’s inspection.

The Notice of Site Visit (LIC 9213) – must remain posted for 30 days during the hours of operation after each site visit by a licensing representative.

Exit interview conducted and report was reviewed with Jennifer Maddocks, Principal.
SUPERVISOR'S NAME: Rita RamosTELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Lilia HernandezTELEPHONE: 424-301-3071
LICENSING EVALUATOR SIGNATURE:
DATE: 02/09/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/09/2024
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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