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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197494302
Report Date: 09/30/2019
Date Signed: 09/30/2019 02:31:37 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:OZZIE GOREN PRESCHOOLFACILITY NUMBER:
197494302
ADMINISTRATOR:LAURA CARDENASFACILITY TYPE:
850
ADDRESS:4330 W SLAUSON AVETELEPHONE:
(323) 421-2662
CITY:LOS ANGELESSTATE: CAZIP CODE:
90043
CAPACITY:40CENSUS: 0DATE:
09/30/2019
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
02:14 PM
MET WITH:Donia LelandTIME COMPLETED:
02:45 PM
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Licensing Program Analysts (LPAs) Karren Starks & Lisa Rios made an announced visit for the purpose of obtaining signature and delivering the pre-licensing report for the inspection conducted on 09/27/19. LPAs met with Site Supervisor, Donia Leland.

LPAs were unable to provide the inspection report at the time of visit due to LPA Rios computer going into consistency check.

LPAs obtained Ms. Leland's signature and issued the report from the day of inspection.

Copy of this report issued.
SUPERVISOR'S NAME: Jennie FerreiraTELEPHONE: (424) 301-3067
LICENSING EVALUATOR NAME: Karren StarksTELEPHONE: (424) 301-3069
LICENSING EVALUATOR SIGNATURE:

DATE: 09/30/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/30/2019
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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