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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197417861
Report Date: 04/27/2023
Date Signed: 04/27/2023 02:37:25 PM


Document Has Been Signed on 04/27/2023 02:37 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
L.A. DAYCARE-NO.WEST, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245



FACILITY NAME:CCRC HEAD START - TULSAFACILITY NUMBER:
197417861
ADMINISTRATOR:TEREZA YEDUYANFACILITY TYPE:
850
ADDRESS:10900 HAYVENHURST AVE.TELEPHONE:
(818) 997-1077
CITY:GRANADA HILLSSTATE: CAZIP CODE:
91344
CAPACITY:34CENSUS: 9DATE:
04/27/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Tereza YedoyanTIME COMPLETED:
02:34 PM
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On 04/27/2023 Licensing Program Analyst ( LPA) Doris Whitmore conducted an unannounced Case Management. LPA spoke to Center Director Teraza Yedoyan.The Unusual Incident Report was submitted to the office. LPA Whitmore was able to review the doctors note that the child was seen in the clinic on 02/23/2023 and able to return back to school on 02/24/2023. Child returned back to school on 02/25/2023. Per Center Director upon returning back to school the rash was no longer present and the child was feeling fine.
SUPERVISOR'S NAME: Karren StarksTELEPHONE: (310) 740-3038
LICENSING EVALUATOR NAME: Doris WhitmoreTELEPHONE: 424-301-3029
LICENSING EVALUATOR SIGNATURE:
DATE: 04/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/27/2023
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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