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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198012843
Report Date: 10/03/2019
Date Signed: 10/03/2019 02:57:41 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:WILL ROGERS PRESCHOOLFACILITY NUMBER:
198012843
ADMINISTRATOR:ANGELA PORTERFACILITY TYPE:
850
ADDRESS:11220 DUNCAN AVENUETELEPHONE:
(310) 604-3063
CITY:LYNWOODSTATE: CAZIP CODE:
90262
CAPACITY:24CENSUS: 21DATE:
10/03/2019
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
09:10 AM
MET WITH:Ms. Valentine, Site SupervisorTIME COMPLETED:
03:15 PM
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Licensing Program Analyst (LPA), Sophia Lord-Richard, conducted a Case Management Incident Report visit to follow up on self reported incident that occurred at Will Rogers Preschool on 08/28/2018.

The El Segundo Child care Office received the incident report on October 15, 2018, by Site Facilitator, Venneka Shannon. Report stated that on August 28, 2018, A parent expressed concerns about the length of time her child was allowed to cry, because the child has an condition that causes her to vomit. The parent stated that she was unhappy with the treatment her child was receiving from the school. The Parent alleged a violation of her child's Personal Rights.

Based upon the information obtained through interviews and documents gathered, there appears to be no violation of Title 22.

LPA reviewed child’s file, obtained documents and conducted Interviews. Based on today’s visit, and interviews conducted, the Incident does not appear to be the results of a regulatory violation of Title 22. The investigation into the above unusual incident does not require any further investigation. An exit interview was conducted, copy of this report, and notice of site visit issued.
SUPERVISOR'S NAME: Sharalyn Jenkins-SweetenTELEPHONE: (424) 301-3054
LICENSING EVALUATOR NAME: Sophia Lord-RichardTELEPHONE: (424) 301-3060
LICENSING EVALUATOR SIGNATURE:

DATE: 10/03/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/03/2019
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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