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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198018055
Report Date: 10/24/2022
Date Signed: 10/24/2022 09:41:46 AM


Document Has Been Signed on 10/24/2022 09:41 AM - It Cannot Be Edited

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:CHILDRENS INSTITUTE/IMPERIAL COURTSFACILITY NUMBER:
198018055
ADMINISTRATOR:AKIDA CROSBYFACILITY TYPE:
850
ADDRESS:11425 GORMAN AVE.TELEPHONE:
(213) 385-5100
CITY:LOS ANGELESSTATE: CAZIP CODE:
90059
CAPACITY:32CENSUS: 0DATE:
10/24/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
08:10 AM
MET WITH:Daniela TroyaTIME COMPLETED:
10:00 AM
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About 8:10AM, Licensing Program Analyst (LPA) T. Tran arrived at 11425 Gorman Ave. Los Angeles CA 90059 to conduct a case management visit for capacity decrease in preschool program and adding the toddler option. Upon entering the facility. LPA met with Daniela Troya, Director of Center Base Services and Carmelita Shorts, Site Supervisor and we toured the facility.

The facility currently licensed for the capacity of 32 preschool. Facility requested a license capacity decrease for preschool program to 16 children and adding 8 toddlers for the total capacity of 24 children. The hours of operation are 8:00 AM – 4:30 PM. The Fire clearance was obtained for the capacity decrease. The facility had sufficient indoor, outdoor space with toilets, sinks, and a changing table to accommodate the 16 preschoolers and 8 toddlers.

LPA reviewed facility's sketch which matched the physical plant of the facility. LPA reviewed the facility's current/updated Designation of Facility Responsibility (LIC 308), current/updated Administrative Organization (LIC309) and a current/updated Personnel record (LIC 500) and current (LIC 412) Monthly Operating Statement. Emergency disaster plan was updated and reflected to the current operation. Food preparation area was cleaned. Separate outdoor area/playground were cushioned and equipped with age appropriate structure/equipment and was free of hazardous material/debris. Drinking water available for children indoor and outdoor. Serviced fire extinguishers, smoke detectors/carbon monoxide detectors were observed.

No deficiency was cited at this time. A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the facility representative, Daniela Troya
SUPERVISOR'S NAME: Trevino CochranTELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Tiffanie TranTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:
DATE: 10/24/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/24/2022
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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