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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197494114
Report Date: 06/13/2023
Date Signed: 06/13/2023 05:04:16 PM


Document Has Been Signed on 06/13/2023 05:04 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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245



FACILITY NAME:STUDIO CITY CHILD CARE, INFANT CENTERFACILITY NUMBER:
197494114
ADMINISTRATOR:NASSIMA MOJABIFACILITY TYPE:
830
ADDRESS:11544 VENTURA BLVDTELEPHONE:
(818) 824-9133
CITY:STUDIO CITYSTATE: CAZIP CODE:
91604
CAPACITY:36CENSUS: 22DATE:
06/13/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:NASSIMA MOJADI, DIRECTORTIME COMPLETED:
05:15 PM
NARRATIVE
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On 06/13/2023 Licensing Program Analyst (LPA) Lisa Clayton arrived at the CCC unannounced. Upon arrival LPA met with teacher Celene Hernandez. Director Nassima Mojabi arrived 25 minutes later, with her husband Zia Mojabi. LPA Clayton observed 22 infants being supervised and cared for by 6 fingerprint cleared staff.

While touring the CCC for a Health and Safety inspection, LPA Clayton observed a teacher supervising 6 sleeping infants (ages 7 months – 18 months), all sleeping on their stomachs.

LPA Clayton reminded the teacher of the Title 22 Regulations regarding Safe Sleep, and instructed the teacher to turn 2 of the infants onto their backs.

Based on LPA Clayton observation of 2 infants less than 12 months old sleeping on their stomach and LPA review of the children’s file confirming the ages of the children, Title 22 Regulations were cited (SEE LIC809D).

Exit interview conducted and report was reviewed with Director Nassima Mojabi. A copy of the report and , Appeal Rights, LIC 9224 and a Notice of Site Visit were provided. Notice of Site visit is to remain posted for 30 days.

SUPERVISOR'S NAME: Karren StarksTELEPHONE: (424) 301-3069
LICENSING EVALUATOR NAME: Lisa ClaytonTELEPHONE: (424) 301-3067
LICENSING EVALUATOR SIGNATURE:
DATE: 06/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/13/2023
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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Document Has Been Signed on 06/13/2023 05:04 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245


FACILITY NAME: STUDIO CITY CHILD CARE, INFANT CENTER
FACILITY NUMBER: 197494114

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/13/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
06/19/2023
Section Cited
CCR
101430(A)

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101430(A)Staff shall place infants up to 12 month of age on their backs for sleeping.
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Director will ensure that staff is trained on the Safe Sleep regulations, and that the Individual Sleep Plan LIC9227 is accurate and current in the childrens files, no later than June 19, 2023
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This requirements was not met as evidenced by LPA Clayton observation of 2 infants ages 8 months and 7 months, sleeping on their stomachs, which poses an immediate Health and Safety risk to children in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Karren StarksTELEPHONE: (424) 301-3069
LICENSING EVALUATOR NAME: Lisa ClaytonTELEPHONE: (424) 301-3067
LICENSING EVALUATOR SIGNATURE:
DATE: 06/13/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/13/2023
LIC809 (FAS) - (06/04)
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