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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 195700208
Report Date: 02/08/2024
Date Signed: 02/08/2024 01:48:23 PM

Document Has Been Signed on 02/08/2024 01:48 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:VALLEY NURSERY SCHOOLFACILITY NUMBER:
195700208
ADMINISTRATOR:KEVIN CHONG YIFACILITY TYPE:
850
ADDRESS:13645 ROSCOE BLVDTELEPHONE:
(818) 782-8630
CITY:PANORAMA CITYSTATE: CAZIP CODE:
91402
CAPACITY: 18TOTAL ENROLLED CHILDREN: 18CENSUS: DATE:
02/08/2024
TYPE OF VISIT:OfficeUNANNOUNCEDTIME BEGAN:
11:02 AM
MET WITH:Kevin Chong Yi, Applicant
TIME COMPLETED:
02:00 PM
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On 02/08/2024 Licensing Program Analyst (LPA) Laticia Thompson conducted an office visit with Kevin Chong Yi (applicant) to review and discuss the Notice of Incomplete Application requested documents. LPA reviewed and discussed the following documents and request needed:

LPA provided guidance of how to complete the LIC 200A and LIC 404, LIC 500 teachers to be hired based on capacity. The facility sketch LIC 999 to include all classrooms numbers, program areas are dedicated to either infant and preschool. The designated outdoor activity areas. Applicant will provide a personnel handbook. Applicant will add portions to lunch and snack menus. Applicant will amend parent handbook per NOIA.

LPA provided applicant with regulations regarding volunteers, teachers aides requirements and LIC 281A Child Care Center Booklet.

LPA discussed waiver request requirements.
SUPERVISORS NAME: Deborah Lowe
LICENSING EVALUATOR NAME: Laticia S Thompson
LICENSING EVALUATOR SIGNATURE: DATE: 02/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/08/2024
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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