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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197416554
Report Date: 01/23/2020
Date Signed: 01/23/2020 11:44:17 AM

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:INTERNATIONAL CHILDREN'S ACADEMYFACILITY NUMBER:
197416554
ADMINISTRATOR:JULIA WEYANDFACILITY TYPE:
850
ADDRESS:1046 S ROBERTSON BLVDTELEPHONE:
(310) 657-6798
CITY:LOS ANGELESSTATE: CAZIP CODE:
90035
CAPACITY:81CENSUS: 34DATE:
01/23/2020
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
11:15 AM
MET WITH:Hamdam "Shanaz" HoorfarTIME COMPLETED:
12:00 PM
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On 1/23/2020 at 11:15 AM Licensing Program Analyst (LPA) Angelica Ramirez conducted a plan of correction visit to verify if the deficiency cited during the 12/19/2019 inspection was completed. Upon arrival LPA met with Director Shanaz who guided the LPA on a tour of the facility. Upon arrival LPA observed six children (ages 2-3 years old) with two teachers in the Shooting Stars classroom, 16 children (ages 3-5 years old) with four teachers in the Super Nova classroom, and 12 children with one teacher in the Kinder-first grade classroom. All adults present today are cleared per the Licensing Information System (LIS).

The deficiency to be corrected was as follows:
Reporting requirements, the facility was to provide a complete director's packet with the name of the new director along with a fully designated teacher to act in the director's name. LPA received a copy of the directors packet for Hamdam "Shanaz" Hoorfar during today's inspection. The designated teacher to act in the director's absence is Danyel Kilgore.

LPA observed the Designation of Responsibility (LIC308) posted on the parents board designating the two individuals mentioned above.

The deficiency was cleared during today's inspection and a copy of the letter clearing the deficiency was provided to Director Shanaz.

Exit interview conducted. A copy of this report along with a notice a site visit were provided.
SUPERVISOR'S NAME: Sharalyn Jenkins-SweetenTELEPHONE: (424) 301-3077
LICENSING EVALUATOR NAME: Angelica RamirezTELEPHONE: (424) 301-3071
LICENSING EVALUATOR SIGNATURE:

DATE: 01/23/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/23/2020
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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