<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198400429
Report Date: 02/18/2022
Date Signed: 02/18/2022 12:15:45 PM


Document Has Been Signed on 02/18/2022 12:15 PM - 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:UNITED PERFORMING ARTS ACADEMYFACILITY NUMBER:
198400429
ADMINISTRATOR:SUMATHY KUMARFACILITY TYPE:
850
ADDRESS:3505 SANTA ANA STTELEPHONE:
(818) 655-9600
CITY:HUNTINGTON PARKSTATE: CAZIP CODE:
90255
CAPACITY:45CENSUS: 0DATE:
02/18/2022
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
11:50 AM
MET WITH:Jamey Dogom, ApplicantTIME COMPLETED:
12:30 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Licensing Program Analyst (LPA) Denise Gibbs conducted an announced follow-up pre-licensing inspection on 2/18/22 at 11:50 AM. LPA met with Jamey Dogmom, Applicant who guided analyst on a tour of the facility.

LPA returned to the facility to inspect the physical plant correction.

LPA observed a storage cabinet bolted to the wall outside to make the area behind the back house inaccessible.

In the front yard LPA observed that the loose brick, wood, metal pipes and all other hazards have been removed from the play area.

All cleaning products have been removed from the children's restroom in the back house.

All storage items have been removed from the play area in the back house.

LPA observed all required postings on the front door where parents will be dropping off and picking up.

LPA reviewed measurement calculations and facility has room for 40 children indoors.

A Child Care license may be granted upon Licensing Program Manager (LPM) Approval. Once licensed, the applicant is required to comply with the terms and limitations stated on the license.



Exit interview was conducted with Jamey Dogmom, applicant. Applicant was given a signed copy of this report.
SUPERVISOR'S NAME: Trevino CochranTELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Denise GibbsTELEPHONE: (323) 558-2794
LICENSING EVALUATOR SIGNATURE:
DATE: 02/18/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/18/2022
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 1