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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191601954
Report Date: 06/05/2024
Date Signed: 06/05/2024 11:31:16 AM

Document Has Been Signed on 06/05/2024 11:31 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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:UCLA EARLY CARE AND EDUCATION-INFANTSFACILITY NUMBER:
191601954
ADMINISTRATOR/
DIRECTOR:		MINOR, ALICIAFACILITY TYPE:
830
ADDRESS:101 S. BELLAGIO DR.TELEPHONE:
(310) 825-5086
CITY:LOS ANGELESSTATE: CAZIP CODE:
90095
CAPACITY: 60TOTAL ENROLLED CHILDREN: 60CENSUS: 28DATE:
06/05/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:20 AM
MET WITH:Interim Director / Rosaura CastilloTIME VISIT/
INSPECTION COMPLETED:
11:45 AM
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On 6/5/24, at 8:20AM, Licensing Program Analysts (LPAs) Joe Katrdzhyan and Roberto Luque Avila conducted an unannounced Case Management Visit to this facility. Upon arrival, LPAs met with Interim Director / Rosaura Castillo, who guided LPAs on a tour of the facility. There were 28 children with 12 staff observed present in the Infant program. LPAs explained the purpose of today's visit is to follow-up on an incident that was reported to Community Care Licensing (CCL) on 5/24/24.

The incident that occurred on 5/24/24, was reported to the Department on 5/24/24, via telephone. The
facility reported the Unusual Incident to the Department within the required 24 hours of occurrence.

Information reported to the Department indicated that Child #1's personal rights may or may not have been violated.

During today's visit, LPAs conducted interviews regarding this incident. LPAs also obtained rosters and other pertinent information regarding this incident.

Based upon information received from the interviews conducted it was determined that the personal rights of Child #1 were not violated. No additional follow up is necessary regarding the incident reported.
There were no deficiencies cited during today’s inspection.

The Notice of Site Visit (LIC 9213) – must remain posted for 30 days during the hours of operation after each site visit by a licensing representative.

An exit interview was conducted with Interim Director / Rosaura Castillo and Appeals Rights provided.
SUPERVISORS NAME: Rita Ramos
LICENSING EVALUATOR NAME: Joe Katrdzhyan
LICENSING EVALUATOR SIGNATURE: DATE: 06/05/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/05/2024
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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