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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191600639
Report Date: 09/20/2022
Date Signed: 09/20/2022 12:25:56 PM

Document Has Been Signed on 09/20/2022 12:25 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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:ST MATTHEWS PARISH SCHOOLFACILITY NUMBER:
191600639
ADMINISTRATOR:DANA BERLINFACILITY TYPE:
850
ADDRESS:1031 BIENVENEDA AVETELEPHONE:
(310) 454-1359
CITY:PACIFIC PALISADESSTATE: CAZIP CODE:
90272
CAPACITY: 105TOTAL ENROLLED CHILDREN: 57CENSUS: 56DATE:
09/20/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:52 AM
MET WITH:Director Christin VardanyanTIME COMPLETED:
12:30 PM
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On 09/20/22 at 10:52 AM, Licensing Program Analyst (LPA) Antonio Almanza, conducted an unannounced Annual Required Inspection for the preschool license. LPA met with Director Christin Vardanyan and toured the facility indoors and outdoors. Days and hours of operation are Monday – Friday 7:50 AM – 3:00 PM. Facility phone number is 310-454-1359. LPA conducted Risk Assessment prior to conducting site visit. During today’s visit there are 56 children and 11 Adults providing care and supervision.

Due to time constraints Annual Required Inspection was not completed and will resume at a future date. Notice of Site Visit and report were provided to the Director Christin Vardanyan.

SUPERVISORS NAME: Rita Ramos
LICENSING EVALUATOR NAME: Antonio Almanza
LICENSING EVALUATOR SIGNATURE: DATE: 09/20/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/20/2022
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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