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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191604221
Report Date: 10/18/2022
Date Signed: 10/18/2022 01:14:53 PM

Document Has Been Signed on 10/18/2022 01:14 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:BERKELEY HALL SCHOOL FOUNDATIONFACILITY NUMBER:
191604221
ADMINISTRATOR:NEWCOMB, BARBARAFACILITY TYPE:
850
ADDRESS:16000 MULHOLLAND DRTELEPHONE:
(310) 476-6421
CITY:LOS ANGELESSTATE: CAZIP CODE:
90049
CAPACITY: 60TOTAL ENROLLED CHILDREN: 60CENSUS: 34DATE:
10/18/2022
TYPE OF VISIT:Case Management - Annual ContinuationUNANNOUNCEDTIME BEGAN:
01:08 PM
MET WITH:Jamie Patrick- DirectorTIME COMPLETED:
01:40 PM
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On 10/18/2022 Licensing Program Analyst (LPA), Suzette Ornelas conducted an unannounced Annual Required Inspection for the preschool license. LPA met with Director, Jamie Patrick, Director, and toured the facility indoors and outdoors. Days and hours of operation are Monday through Friday 7:30a to 3:30p.

Continuation was needed to complete the inspection care tool that was not completed during the initial report.

Exit Interview was conducted.
This report shall be made available to the public upon request. LIC 9213 Notice of Site Visit is provided and required to be posted for 30 days.
SUPERVISORS NAME: Lisa Rios
LICENSING EVALUATOR NAME: Suzette Ornelas
LICENSING EVALUATOR SIGNATURE: DATE: 10/18/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/18/2022
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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