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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 195700691
Report Date: 02/13/2026
Date Signed: 02/13/2026 02:32:09 PM

Document Has Been Signed on 02/13/2026 02:32 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:LITTLE SCHOLARS ACADEMYFACILITY NUMBER:
195700691
ADMINISTRATOR/
DIRECTOR:		CRYSTAL THOMPSONFACILITY TYPE:
860
ADDRESS:4168 W SLAUSON AVETELEPHONE:
(800) 515-1443
CITY:LOS ANGELESSTATE: CAZIP CODE:
90043
CAPACITY: 30TOTAL ENROLLED CHILDREN: 12CENSUS: 10DATE:
02/13/2026
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:06 AM
MET WITH:Crystal Thompson - licenseeTIME VISIT/
INSPECTION COMPLETED:
02:45 PM
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On 2/13/2026 Licensing Program Analyst (LPA) Jillinda Chandler and Lisa Clayton made an un-announced visit to Little Scholars Academy located at 4168 W. Slauson Ave. Los Angeles, CA. 90043 for the purpose of conducting a "Licensee Initiated" inspection. The center is a single-story building with 3 classrooms; according to provided facility sketches, rooms 1 and 2 will be dedicated to preschool activities and room 3 ( previously facility 197493692 school-age/closed)will be used for infant care. The licensee is requesting to add an infant component to an existing license #197493691 (preschool). The licensee is requesting a capacity of 10 infants ages 1 year - 24 months and 20 pre-school children ages 2-until entry into first grade. LPA met with Crystal Thompson (licensee) who provided a tour of the facility. Daycare will be conducted Monday-Friday/7:30 a.m. - 5:30 p.m. There is an approved fire clearance on file conducted on 12/18/2025 by Inspector I. Felix of the L.A. City Fire Department.
NAME OF LICENSING PROGRAM MANAGER: Deborah Lowe
NAME OF LICENSING PROGRAM ANALYST: Jillinda Chandler
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 02/13/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/13/2026
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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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: LITTLE SCHOLARS ACADEMY
FACILITY NUMBER: 195700691
VISIT DATE: 02/13/2026
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The following was observed of the:

INDOOR ACTIVITY SPACE

Fire extinguishers were 2AB10C or larger.

Carbon monoxide and smoke detectors were observed in operable condition.

First aid kits were available with the required essentials: scissors, bandages, tweezers, ointments, manuals and thermometer.

Age-appropriate furniture and equipment was observed in good repair. LPA observed toys for infants that provided auditory stimulation, visual stimulation, tactile stimulation and manipulative skills, no walkers were observed during todays inspection.

Cots were observed for napping in good repair; applicant was informed that bedding must be removed and stored separately when cots are stacked. There were no cribs observed per the requested age range for infants (1-24 months) these infants will be able to crawl out off cribs and are able to nap on cots.

Cubbies were observed for children’s belongings.

Drinking water will be provided through filtered water dispensers and the use of paper cups.

NAME OF LICENSING PROGRAM MANAGER: Deborah Lowe
NAME OF LICENSING PROGRAM ANALYST: Jillinda Chandler
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 02/13/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/13/2026
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: LITTLE SCHOLARS ACADEMY
FACILITY NUMBER: 195700691
VISIT DATE: 02/13/2026
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The facility has central heating and cooling. LPA observed a barricaded fireplace in the middle section of room 1, no open face heaters were observed during todays inspection.

Windows were in good repair free of chipping paint, window sills needed to be made free of dirt, insects, or debris.

Adequate lighting was observed.

LPA observed trash cans used for solid waste with tight-fitting lids.


Disinfectants, cleaning solutions, toxins and other poisons were observed inaccessible to children in care.

Children will isolate within their respective classrooms away from other children. Applicant was informed that there shall be a cot, mat, or crib readily available for ill children and that these children must be under direct visual supervision at all times. Children will use their dedicated restrooms with disinfecting and sanitation after each use.

The facility was equipped with working telephones, and cameras in each classroom and outdoors, per the licensee cameras data is retained for a maximum of seven days.

The classrooms were clean in good repair. Rugs and flooring were in fair condition, no tripping hazards were observed during todays inspection.

NAME OF LICENSING PROGRAM MANAGER: Deborah Lowe
NAME OF LICENSING PROGRAM ANALYST: Jillinda Chandler
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 02/13/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/13/2026
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: LITTLE SCHOLARS ACADEMY
FACILITY NUMBER: 195700691
VISIT DATE: 02/13/2026
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Parents and authorized adults will sign children in and out, using an electronic signing device. The applicant was informed that sign-in sheets must be maintained for a minimum of 30 days and readily available for review at the request of the department or its representative.

The required postings were also updated and posted; applicant was advised that the postings must be posted in a prominent area for viewing at all times during day care operations.

FOOD SERVICE:

Meals will be provided by the center. Applicant was informed there must be an adequate supply of emergency foods readily available in the case of emergencies. Applicant was also informed There shall be an individual feeding plan for each infant per Title 22, section 101427.

LPA observed a kitchen, with a sink, storage for foods and a refrigerator and freezer with thermometers, foods, toxins and/or other chemicals were stored separately, and LPA did not observe any expired or contaminated foods. Licensee was reminded that open foods shall be labeled with open date and expiration or best used dates.

LPAs observed an open floor kitchen plan, children enter class room 2 through this area. Licensee shall make the kitchen area inaccessible to children in care.

NAME OF LICENSING PROGRAM MANAGER: Deborah Lowe
NAME OF LICENSING PROGRAM ANALYST: Jillinda Chandler
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 02/13/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/13/2026
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: LITTLE SCHOLARS ACADEMY
FACILITY NUMBER: 195700691
VISIT DATE: 02/13/2026
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Center has devised an Incidental Medical Service (IMS) plan to provide to parents of children with allergies (epi-pen), asthmatic (inhalers) glucose monitoring (diabetics), and children needing gastrostomy tube (g-tube) feeding. IMS was discussed with the applicant.

RESTROOMS

THERE WERE:


Preschool: 2 sinks and 2 toilets available for children use
Infants: 1 sink(s) and 1 toilet(s) available for children use
The restrooms were clean and sanitized with the necessary toiletries, sinks and toilets were operable and in good repair. Faucets delivered cold water. Changing tables were within reach of a sink, padding surface was at least one inch thick, covered with washable vinyl or plastic with raised sides at least three inches high. Applicant was informed there shall be a written toilet-training plan for infants being toilet trained per Title 22, section 101428 - Infant Care Personal Services. The adult restroom (in room 2) shall be made inaccessible to children in care. Water bottle storage shall be secured and cleaning equipment shall be stored separately.

OUTDOOR ACTIVITY SPACE

Age-appropriate toys and equipment were observed in good condition. LPAs observed a climbing play structure in the outdoor activity area (zone 2) manufactured for children ages 2- 8 years of age, infants shall not be permitted to use this equipment.

NAME OF LICENSING PROGRAM MANAGER: Deborah Lowe
NAME OF LICENSING PROGRAM ANALYST: Jillinda Chandler
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 02/13/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/13/2026
LIC809 (FAS) - (06/04)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: LITTLE SCHOLARS ACADEMY
FACILITY NUMBER: 195700691
VISIT DATE: 02/13/2026
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Artificial grass was observed for cushioning in good repair. Licensee shall ensure the entry pathway is level to grassed area to prevent a tripping hazard, a rug was removed from the east area of the play yard to prevent an observed tripping hazard. LPA observed exposed concrete pole on the play yard in need of padding, licensee will send pictures of the padded poles. Water hose faucet on the concrete area shall be made inaccessible or covered.

Water was readily available for an outdoor water source; children use their personal water bottles for drinking.

LPA observed sail shades for shade and benches for resting.

LPA did not observe any bodies of water during today’s inspection. Director was informed that all standing water should be removed immediately after each use.

MEASUREMENTS:


Indoor Activity Space:
Preschool equals 841.10 square feet, which will accommodate the requested capacity.
Classrooms: 1 and 2 will be dedicated to preschool activities

Infant’s measurements equals 352.17 square feet, which will accommodate the requested capacity.
Classroom(s) 3 will be dedicated to infant activities
NAME OF LICENSING PROGRAM MANAGER: Deborah Lowe
NAME OF LICENSING PROGRAM ANALYST: Jillinda Chandler
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 02/13/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/13/2026
LIC809 (FAS) - (06/04)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: LITTLE SCHOLARS ACADEMY
FACILITY NUMBER: 195700691
VISIT DATE: 02/13/2026
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Outdoor Activity Space

Outdoor activity measurements equals 3525 square feet, which will accommodate the maximum requested capacity, however
licensee is requesting a waiver for Title 22, section 101238.2(a)- There shall be at least 75 square feet per child of outdoor activity space based on the total licensed capacity.
101438.2(b) Outdoor Activity Space for Infants - (a) In addition to Section 101238.2(a), the following shall apply: (b) Infant Outdoor activity space shall be physically separate from space used by children in the child care center and school-age child care center components. the waiver is being requested for the purpose of shared outdoor space preschool and infants.

THE FOLLOWING WAS DISCUSSED REGARDING INFANT CARE (ref. Title 22, subchapter 2)

There shall be a ratio of one teacher for every four infants in attendance. When engaged in activities away from the center, there shall be a minimum of one adult to every two infants in attendance. This ratio may include authorized representatives of infants in care and adult volunteers to supplement the staff-infant ratio. There shall be one teacher to every 12 sleeping infants provided the remaining staff necessary to meet the ratios specified in the above are immediately available at the center.

NAME OF LICENSING PROGRAM MANAGER: Deborah Lowe
NAME OF LICENSING PROGRAM ANALYST: Jillinda Chandler
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 02/13/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/13/2026
LIC809 (FAS) - (06/04)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: LITTLE SCHOLARS ACADEMY
FACILITY NUMBER: 195700691
VISIT DATE: 02/13/2026
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Prior to the infant's first day at the center, the infant care center director or assistant director shall complete a needs and services plan for the infant.

Staff shall place infants up to 12 months of age on their backs for sleeping. An infant shall not be swaddled while in care. An infant's head shall not be covered while sleeping. If an infant falls asleep before being placed in a crib, staff shall move the infant to a crib as soon as possible.



Step stools, highchairs or low-wheeled feeding tables and any such equipment used for assisting or seating an infant shall have broad-base legs.

If sufficient potty chairs are not available for the number of infants being toilet trained, a combination of potty chairs and toilets with training seats may be used to meet the ratios Infants shall not be permitted to play with potty chairs.
A combination of toys shall provide and encourage: Auditory stimulation, Visual stimulation, Tactile stimulation. Manipulative skills.

Children shall not commingle with other components or programs at anytime
NAME OF LICENSING PROGRAM MANAGER: Deborah Lowe
NAME OF LICENSING PROGRAM ANALYST: Jillinda Chandler
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 02/13/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/13/2026
LIC809 (FAS) - (06/04)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: LITTLE SCHOLARS ACADEMY
FACILITY NUMBER: 195700691
VISIT DATE: 02/13/2026
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Based on today’s inspection, the facility shall be recommended for a maximum capacity of 30 children. 20 preschool children determined at the request of the licensee.

Also discussed;

To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.



applicant was reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.
NAME OF LICENSING PROGRAM MANAGER: Deborah Lowe
NAME OF LICENSING PROGRAM ANALYST: Jillinda Chandler
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 02/13/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/13/2026
LIC809 (FAS) - (06/04)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: LITTLE SCHOLARS ACADEMY
FACILITY NUMBER: 195700691
VISIT DATE: 02/13/2026
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Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for
drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test.
For child care center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1-CCP).
• CCC TESTING was completed
LPA referred applicant to the Department website for lead: Lead Toxicity Prevention and Water Testing Information.

LPA discussed the safe sleep regulations with applicant and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource.

LPA also informed applicant of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.
NAME OF LICENSING PROGRAM MANAGER: Deborah Lowe
NAME OF LICENSING PROGRAM ANALYST: Jillinda Chandler
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 02/13/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/13/2026
LIC809 (FAS) - (06/04)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: LITTLE SCHOLARS ACADEMY
FACILITY NUMBER: 195700691
VISIT DATE: 02/13/2026
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Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. When any IMS is provided, an updated Plan of Operation that includes IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-care-centers/. PIN 22-05-CCP Page Five

Applicant was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain childcare by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California.

A Notice of Site Visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the licensee Crystal Thompson. This report will emailed to the licensee.
NAME OF LICENSING PROGRAM MANAGER: Deborah Lowe
NAME OF LICENSING PROGRAM ANALYST: Jillinda Chandler
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 02/13/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/13/2026
LIC809 (FAS) - (06/04)
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