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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198015308
Report Date: 09/19/2019
Date Signed: 09/19/2019 11:34:40 AM

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:WEST SIDEFACILITY NUMBER:
198015308
ADMINISTRATOR:LETICIA RICO NUNEZFACILITY TYPE:
850
ADDRESS:9200 STATE STREETTELEPHONE:
(323) 563-0067
CITY:SOUTH GATESTATE: CAZIP CODE:
90280
CAPACITY:65CENSUS: 57DATE:
09/19/2019
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
08:25 AM
MET WITH:Leticia Rico NunezTIME COMPLETED:
11:52 AM
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A Case Management site inspection was conducted today by Licensing Program Analysts (LPAs) Raul Navarro and Fabiola Vasquez to inspect and measure the preschool facility for a capacity determination. Applicant is currently Licensed for a preschool program with a capacity of 65. Applicant is requesting to increase the preschool capacity to 80. Applicant is going to use an additional classroom to accommodate the additional 15 children. The preschool program operates from Monday through Friday 7:30AM - 5:00PM.

The fire clearance was granted for 80 preschool children on 08/01/2019. Facility has 6 toilets and 6 sinks available for the children

The following measurements were taken and totaled:

Indoor Space:
Additional Classroom (West side 4) Total Indoor Activity space: 726.28 sq. ft. / 35 sq. ft. = 20 additional children

The Outdoor Activity space was previously measured, Facility Evaluation Report, dated 08/04/2009.
LPAs re-measured the outdoor activity space on today's date. Outdoor activity space: 5213.1875 sq. ft./ 75 sq. ft. = 69 children.

Based on the outdoor measurements, the facility can only be licensed for 69 children. Per Director Leticia Rico Nunez, they will request a waiver for a capacity increase of 80 children. Director stated the children will use the outdoor activity space in a scattered schedule. Capacity of children using the outdoor play area will not exceed 69 children at one time.
Report continues- Page 1 of 2
SUPERVISOR'S NAME: Karen ChambersTELEPHONE: (323) 980-4934
LICENSING EVALUATOR NAME: Raul NavarroTELEPHONE: 323-981-3388
LICENSING EVALUATOR SIGNATURE:

DATE: 09/19/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/19/2019
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, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: WEST SIDE
FACILITY NUMBER: 198015308
VISIT DATE: 09/19/2019
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Exit interview was conducted with Director Leticia Rico Nunez. The Director was provided a copy of their appeal rights (LIC 9058) and their signature on this form acknowledges receipt of these forms.

The Notice of Site Visit (LIC 9213) – must remain posted for 30 days during the hours of operation after each site inspection by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00.

Report ends- Page 2 of 2
SUPERVISOR'S NAME: Karen ChambersTELEPHONE: (323) 980-4934
LICENSING EVALUATOR NAME: Raul NavarroTELEPHONE: 323-981-3388
LICENSING EVALUATOR SIGNATURE:

DATE: 09/19/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/19/2019
LIC809 (FAS) - (06/04)
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