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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197419005
Report Date: 03/30/2023
Date Signed: 03/30/2023 03:00:10 PM


Document Has Been Signed on 03/30/2023 03:00 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:CII/SOUTH VERMONT HEAD STARTFACILITY NUMBER:
197419005
ADMINISTRATOR:GEORGETTE BRADLEYFACILITY TYPE:
850
ADDRESS:9022 S. VERMONTTELEPHONE:
(213) 385-5100
CITY:LOS ANGELESSTATE: CAZIP CODE:
90044
CAPACITY:55CENSUS: DATE:
03/30/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
01:10 PM
MET WITH: Benita ThompsonTIME COMPLETED:
03:00 PM
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On 03/30/2023 Licensing Program Analyst ( LPA) Doris Whitmore conducted an attempted unannounced Case Management for the purpose of incident Report( UIR) that occurred on 01/25/2023. At the time of the there were no children. There was a total of 10 teachers present during the visit the children were on Spring Break. Upon arrival, LPA met with Teacher Claudia Martinez and informed the nature of the visit. LPA was following up from last visit on 02/16/2023 to continue with the Case Management. LPA Whitmore interviewed Staff #2 and at the time of the incident that occurred on 01/25/2023 staff #2 was absent. LPA Whitmore was unable to interview child#1 due to Spring Break. Staff#2 stated that child#1 has been absent two weeks.
Based on the information obtained throughout the course of the investigation which includes interviews from Staff. and speaking to H.R. Staff #1 was not present when the incident occurred. There are no deficiencies an exit interview was conducted. A copy of this report and Notice of Site Visit was issued.
SUPERVISOR'S NAME: Karren StarksTELEPHONE: (310) 740-3038
LICENSING EVALUATOR NAME: Doris WhitmoreTELEPHONE: 424-301-3029
LICENSING EVALUATOR SIGNATURE:
DATE: 03/30/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/30/2023
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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