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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197494347
Report Date: 08/03/2023
Date Signed: 08/03/2023 04:30:22 PM


Document Has Been Signed on 08/03/2023 04:30 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:BRELLA PLAYA VISTA - INFANTFACILITY NUMBER:
197494347
ADMINISTRATOR:KENNER RAKOZFACILITY TYPE:
830
ADDRESS:12746 W. JEFFERSON BL. #3-3100TELEPHONE:
(424) 425-7500
CITY:LOS ANGELESSTATE: CAZIP CODE:
90094
CAPACITY:32CENSUS: 27DATE:
08/03/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Director Lisa Perez TIME COMPLETED:
02:00 PM
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On 8/3/2023 Licensing Program Analysts (LPA) Dalicia Adkins conducted an unannounced case management visit. LPA Adkins met with director Lisa Perez, LPA informed director about the purpose of the visit and was granted entry into the facility. LPA was guided on a tour of the facility. LPA observed nine teachers supervising twenty nine children.

The purpose of today's visit is to investigate a self- reported unusual Incident (LIC 624) reported to Community Care Licensing on 7/26/23. This Report indicates that there was a violation of children personal rights.

During today's visit 8/3/23 LPA conducted classroom observations and interviewed staff. LPA collected and reviewed the following supportive records: children’s roster, personnel roster, personnel records, staff training roster, parent incident notification, suspected child abuse report and witness statements.

LPA will follow up with a manager for guidance for the next appropriate steps. There were no citations issued during today 8/3/2023 visit.

Child Care Advocate Program: The child Care Advocate Program (CCAP) promotes the delivery of quality child care in California. You may contact the CCAP directly: Phone number (916) 654-1541, email address: childcareadvocatesprogram@dss.ca.gov Child Care Quarterly Update Newsletter: recommended to sign up, link www.ccld.ca.gov

LPA Adkins reviewed this report with director Ariana Villatoro and copy given. Notice of site visit given and must be posted for 30 days. Exit interview conducted.

SUPERVISOR'S NAME: Maureen NealTELEPHONE: (424) 301-3042
LICENSING EVALUATOR NAME: Dalicia AdkinsTELEPHONE: (424) 301-3064
LICENSING EVALUATOR SIGNATURE:
DATE: 08/03/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/03/2023
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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