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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197494865
Report Date: 07/06/2021
Date Signed: 07/06/2021 01:17:26 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:WISEBURN PRESCHOOL ENRICHMENTFACILITY NUMBER:
197494865
ADMINISTRATOR:KAREN CHAPKHANEHFACILITY TYPE:
850
ADDRESS:12501 ISIS AVENUETELEPHONE:
(310) 748-8834
CITY:HAWTHORNESTATE: CAZIP CODE:
90250
CAPACITY:156CENSUS: 0DATE:
07/06/2021
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
10:25 AM
MET WITH:Karen Chapkhaneh - Site SupervisorTIME COMPLETED:
01:15 PM
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On 07/06/2021, Licensing Program Analyst (LPA) Claudia Escobedo met with Site Supervisor - Karen Chapkhaneh to conduct a prelicensing visit. This is an application for 156 preschool-age children, ages 3 years to 5 years old. The days and hours of operation are Monday - Friday 7:30 a.m. - 5:30 p.m. The fire clearance was approved on 06/25/2021 for 156 children.

During today's visit LPA Escobedo was unable to complete the prelicensing visit due to the facility not being ready for licensing:
  • Outdoor play structures have not been installed.
  • Room 5 is currently being occupied through July 23, 2021 by the school district's special education department
  • Classrooms are currently equipped with items and/or equipment that will not be used by the licensed facility, including physical therapy equipment and classroom dividers.

Facility to submit an outdoor supervision plan and log for ensuring children are always supervised and accounted for.

A prelicensing visit will be rescheduled when the facility has equipped the areas and removed any items that will not be associated with the facility.
SUPERVISOR'S NAME: Peter FloresTELEPHONE: (424) 301-3077
LICENSING EVALUATOR NAME: Claudia EscobedoTELEPHONE: (424) 301-3044
LICENSING EVALUATOR SIGNATURE:

DATE: 07/06/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/06/2021
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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