197419123-7-9-2025-30-CC-LCLN-DJENQK-20250709104005

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197419123
Report Date: 07/09/2025
Date Signed: 07/09/2025 10:40:21 AM

Document Has Been Signed on 07/09/2025 10:40 AM - 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:	BUILDING BLOCKS CHRISTIAN ACADEMY		FACILITY NUMBER:	197419123
ADMINISTRATOR/ DIRECTOR:	ORR, KAYLEN		FACILITY TYPE:	850
ADDRESS:	3734 CENTINELA AVENUE		TELEPHONE:	(310) 397-7500
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90066
CAPACITY: 35	TOTAL ENROLLED CHILDREN: 35	CENSUS: 15	DATE:	07/09/2025
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	08:30 AM
MET WITH:	KAYLEN ORR, DIRECTOR		TIME VISIT/ INSPECTION COMPLETED:	11:00 AM

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On 07/09/2025 Licensing Program Analyst (LPA) Lisa Clayton made an announced visit to the Building Blocks Christian Academy, located on the Hope Lutheran Church premises. LPA Clayton observed 15 children in care, being supervised appropriately by 5 fingerprint cleared staff.

The purpose of today’s visit is to conduct a "Case Management - Licensee Initiated" inspection. The licensee is requesting to add 2 additional indoor activity areas to the existing license. The Center currently has a capacity of 35.

LPA was greeted by Director Kaylen Orr and a tour of the center was conducted.

LPA measured both the Sanctuary, and the Church Annex as follows:

The Annex - total measurements = 385.0 which will accommodate 11 children

The Sanctuary - total measurements = 1834.0 which will accommodate 52 children

The Main Classroom - total measurements= 1242 which will accommodate 35 children

Karren Starks	TELEPHONE: (310) 740-3038
Lisa Clayton	TELEPHONE: (424) 301-3206
	DATE: 07/09/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/09/2025

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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California Health & Human Services Agency

California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:

Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.

Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)

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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

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: BUILDING BLOCKS CHRISTIAN ACADEMY	FACILITY NUMBER: 197419123
	VISIT DATE: 07/09/2025

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The Annex will be used as a small group studies room and the Sanctuary will be used for Chapel as well as an indoor activity space when inclement weather conditions are present.

There is a “push” Fire Alarm system and 3A:40B:C Fire Extinguishers in the Annex, and 2 3A:40B:C Fire Extinguishers in the Sanctuary, the CCC has a Fire Clearance, approved by Gabriel Lopez with the Los Angeles City Fire Department, Institutions Unit on 05/15/2025.

LPA Clayton advised Director Kaylen that the children will continue use the bathrooms in the Main Classroom, and the restrooms in the Sanctuary are off limits to children in care.

Based on today’s measurements, and observations, the CCC’s request to license the Sanctury and Church Annex as on-limits to children in care is approved. There are no changes to the license capacity, and no changes to the ages of children to whom care is to be provided.

An exit interview was conducted, a copy of this report and notice of site visit was provided to Director.

SUPERVISOR'S NAME: Karren Starks	TELEPHONE: (310) 740-3038
LICENSING EVALUATOR NAME: Lisa Clayton	TELEPHONE: (424) 301-3206
LICENSING EVALUATOR SIGNATURE:	DATE: 07/09/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/09/2025

LIC809 (FAS) - (06/04)

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