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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197408363
Report Date: 10/18/2019
Date Signed: 10/21/2019 03:17:41 PM

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:IQRA ELEMENTARY SCHOOLFACILITY NUMBER:
197408363
ADMINISTRATOR:RUBINA AHMEDFACILITY TYPE:
850
ADDRESS:11439 ENCINO AVENUETELEPHONE:
(818) 582-6024
CITY:GRANADA HILLSSTATE: CAZIP CODE:
91344
CAPACITY:60CENSUS: 5DATE:
10/18/2019
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
11:25 AM
MET WITH:Rubina AhmedTIME COMPLETED:
12:30 PM
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Licensing Program Analysts (LPAs), Silva Garibyan met with the director, Rubina Ahmed, and conducted a Case Management visit ( Well-ness Check). LPA toured and inspected the preschool in accordance with the facility sketch on 10/18/2019 at 11:35 a.m. The director stated that the facility has been impacted by SADDLERIDGE FIRE. Due to the POOR AIR QUALITY the facility was closed on 10/11/19 and also on Monday, 10/14/2019 due to holiday. All families were notified of closure by group text.
There were 5 children and two teachers present at the time of the visit. The facility is open today and in normal operation.
A copy of this report along with a Notice of Site Visit were issued and explained to licensee.

SUPERVISOR'S NAME: Mary RuizTELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Silva GaribyanTELEPHONE: (424) 301-3062
LICENSING EVALUATOR SIGNATURE:

DATE: 10/18/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/18/2019
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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