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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197493692
Report Date: 09/27/2019
Date Signed: 09/27/2019 02:04:12 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:LITTLE SCHOLARS ACADEMYFACILITY NUMBER:
197493692
ADMINISTRATOR:CRYSTAL THOMPSONFACILITY TYPE:
840
ADDRESS:4168 WEST SLAUSON AVENUETELEPHONE:
(323) 401-7101
CITY:LOS ANGELESSTATE: CAZIP CODE:
90043
CAPACITY:10CENSUS: 3DATE:
09/27/2019
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
01:02 PM
MET WITH:Crystal ThompsonTIME COMPLETED:
02:20 PM
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LPA Christopher Garlington made an unannounced Case Management visit to the facility and met with Crystal Thompson licensee and was guided on a tour of the facility according to facility sketches.

LPA delivered the Case Closure letter from the Caregivers Background Check Bureau (CBCB) and explained that Jacqueline Oliver, (Personnel I.D. 7505110071) has been removed from the facility.

LPA Garlington provided a copy of the Case Closure letter along with a copy of the Addendum to Notification of Parent’s Rights (LIC 995B) to the Licensee. LPA explained that each respective parent must sign the Addendum to Notification of Parent’s Rights (LIC 995B) and a copy placed in the file of each child.

A copy of the Notice of Site Visit was also provided to the facility.
SUPERVISOR'S NAME: Sharalyn Jenkins-SweetenTELEPHONE: (424) 301-3054
LICENSING EVALUATOR NAME: Christopher GarlingtonTELEPHONE: (424) 301-3056
LICENSING EVALUATOR SIGNATURE:

DATE: 09/27/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/27/2019
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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