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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197494761
Report Date: 01/24/2022
Date Signed: 01/25/2022 01:09:40 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:GOOD SHEPHERD CATHOLIC SCHOOLFACILITY NUMBER:
197494761
ADMINISTRATOR:NAJAE WILLIAMSFACILITY TYPE:
840
ADDRESS:148 S LINDEN DRIVETELEPHONE:
(310) 641-4400
CITY:BEVERLY HILLSSTATE: CAZIP CODE:
90212
CAPACITY:30CENSUS: 0DATE:
01/24/2022
TYPE OF VISIT:OfficeANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Brad Lupien, CEO / ApplicantTIME COMPLETED:
11:30 AM
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INFORMAL MEETING
An informal office meeting was scheduled virtually via Microsoft Teams in the El Segundo Child Care Regional Office on January 24, 2022 at 11:00 a.m.

The meeting attendees are as follows:
Claudia Escobedo, Licensing Program Manager (LPM)
Deborah Lowe, Licensing Program Analyst (LPA)
Veronica Wheatley, Licensing Program Analyst (LPA)
Brad Lupien, CEO of Good Sports Plus LTD, (DBA) Arc, Applicant

The purpose of this meeting is to review and discuss with the CEO of Good Sports Plus, LTD (DBA) Arc concerns the Department has regarding the application process and operating without a license.

Operating without a license is in reference to Facility 197494929.

LPM Escobedo reviewed the concerns regarding the history of contact during the application process.

LPA Wheatley reviewed the list of pending application documents.

The following pending application documents are needed before licensure will be considered. Pending documents are due by 01/31/2022:

- Updated Director Packet which includes the following documents for new director:

  • LIC 508 Criminal Record Statement
  • LIC 308 Designation of Facility Responsibility
SUPERVISOR'S NAME: Karren StarksTELEPHONE: (434) 301-3069
LICENSING EVALUATOR NAME: Deborah LoweTELEPHONE: (424) 301-3016
LICENSING EVALUATOR SIGNATURE:

DATE: 01/24/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/24/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
Page: 1 of 2
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: GOOD SHEPHERD CATHOLIC SCHOOL
FACILITY NUMBER: 197494761
VISIT DATE: 01/24/2022
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  • LIC 501 Personnel Record
  • LIC 503 Health Screening with TB test
  • First Aid/ CPR
  • Preventive Health & Safety Practices Training
  • Orientation Training
  • LIC 9108 Statement Acknowledging Requirement to Report Suspected Child Abuse
  • Mandated Reporter Training – General and Child Care Provider
  • Immunization's – proof of MMR, DTap, and Flu

- Background Clearance – Associate Designated Applicant, new director, and any staff hired.

- MOU - Memorandum of Understanding between Good Sports and Good Shepherd.

- LIC 610 Emergency Disaster Plan – Amend to include two relocation sites.

- LIC 401 Monthly Operating Statement – Amend to use calculations per requested capacity of 30. (document received shows capacity of 19)

Resources provided to Brad Lupien:

Technical Support Program (TSP) – Flyer was provided with report.

Child Care Center Provider videos: https://ccld.childcarevideos.org/child-care-center-operators/

An exit interview was conducted, and a copy of this report was provided to CEO, Brad Lupien.

SUPERVISOR'S NAME: Karren StarksTELEPHONE: (434) 301-3069
LICENSING EVALUATOR NAME: Deborah LoweTELEPHONE: (424) 301-3016
LICENSING EVALUATOR SIGNATURE:

DATE: 01/24/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/24/2022
LIC809 (FAS) - (06/04)
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