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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197402054
Report Date: 09/05/2024
Date Signed: 09/05/2024 04:16:33 PM

Document Has Been Signed on 09/05/2024 04:16 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/
DIRECTOR:		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: 32DATE:
09/05/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:31 PM
MET WITH:Uchenna Okereke, PrincipalTIME VISIT/
INSPECTION COMPLETED:
04:25 PM
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Licensing Program Analyst (LPA) Lilia Hernandez conducted an unannounced case management inspection on 09/05/2024 due to self reported incidences that occurred at the facility. LPA arrived at the facility at 1:31PM and met with Uchenna Okereke, Principal. There were 32 children and 6 staff present upon arrival.

The two incidences that occurred on 08/23/2024 were reported to the Department on 08/23/2024, 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 Staff #1 may or may not have violated the personal rights of Child #1 while in care. The second incident that occurred on the same day, 08/23/2024, indicates that there may have been a lapse of care and supervision when Child #1 hit and cause injury to Child #2.

LPA conducted interviews with Staff #1 and Staff #2. LPA also obtained a copy of the facility roster. During todays visit, LPA conducted an observation of care and supervision of children.

Based upon information LPA received from the interviews conducted today, additional information is needed to determined if the personal rights of Child #1 were violated. Additional information is also needed to determine if there was a lapse in care and supervision when Child #1 hit and cause injury to Child #2.

There were no deficiencies cited during today’s inspection.

The Notice of Site Visit was given and must remain posted for 30 days during the hours of operation after each site visit by a licensing representative.

Exit interview was conducted and report was reviewed with Uchenna Okereke, Principal.
SUPERVISORS NAME: Rita Ramos
LICENSING EVALUATOR NAME: Lilia Hernandez
LICENSING EVALUATOR SIGNATURE: DATE: 09/05/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/05/2024
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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