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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197402054
Report Date: 02/09/2024
Date Signed: 02/09/2024 12:49:15 PM

Document Has Been Signed on 02/09/2024 12:49 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:LASSEN ELEMENTARY SCHOOL PRESCHOOLFACILITY NUMBER:
197402054
ADMINISTRATOR:MOORE, LANCEFACILITY TYPE:
850
ADDRESS:15017 SUPERIOR STREET K-3,K-4TELEPHONE:
(818) 892-8618
CITY:SUPELVEDASTATE: CAZIP CODE:
91343
CAPACITY: 46TOTAL ENROLLED CHILDREN: 46CENSUS: 14DATE:
02/09/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
08:45 AM
MET WITH:Uchenna Okereke, PrincipalTIME COMPLETED:
01:10 PM
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Licensing Program Analysts (LPAs) Tatiana Bickham and Lilia Hernandez conducted an unannounced case management inspection to follow up on an incident that was reported to the department. LPAs arrived at the facility at 8:45AM and met with Uchenna Okereke, Principal, who guided LPA on a tour of the facility. There were 14 children and 4 staff present upon arrival.

The incident that occurred on 10/20/2023, was reported to the Department on 12/08/2023, via telephone. The facility did not reported the Unusual Incident to the Department within the required 24 hours of occurrence.

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

LPAs conducted interviews and obtained documentation during this visit.

Based upon information received from the interviews conducted it was determined that the personal rights of child #1 were not violated.

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.

Exit interview conducted and report was reviewed with Uchenna Okereke, Principal.
SUPERVISORS NAME: Rita Ramos
LICENSING EVALUATOR NAME: Lilia Hernandez
LICENSING EVALUATOR SIGNATURE: DATE: 02/09/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/09/2024
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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