197402054-2-11-2026-58-CC-NMOY-DR7UUE-20260211145324

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197402054
Report Date: 02/11/2026
Date Signed: 02/11/2026 02:54:02 PM

Document Has Been Signed on 02/11/2026 02:54 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 PRESCHOOL		FACILITY NUMBER:	197402054
ADMINISTRATOR/ DIRECTOR:	MOORE, LANCE		FACILITY TYPE:	850
ADDRESS:	15017 SUPERIOR STREET K-3,K-4		TELEPHONE:	(818) 892-8618
CITY:	SUPELVEDA	STATE: CA	ZIP CODE:	91343
CAPACITY: 46	TOTAL ENROLLED CHILDREN: 40	CENSUS: 35	DATE:	02/11/2026
TYPE OF VISIT:	Required - 3 Year	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	09:15 AM
MET WITH:	Uchenna Okereke, Principal		TIME VISIT/ INSPECTION COMPLETED:	03:03 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	Licensing Program Analyst (LPA), Nathanael Mooberry, and Licensing Program Manager (LPM), Raul Navarro, conducted an unannounced annual visit to the above facility on 02/11/2026. LPA and LPM arrived at the facility at 9:15AM, identified selves and met with Uchenna Okereke, Principal, who guided LPA and LPM on a tour of the facility. LPA and LPM provided Principal with a copy of the LIC 125 Entrance Checklist to help facilitate the inspection. This is a Pre-School Program which consists of 2 classrooms (K-3 and K-4) that is currently licensed for 46 children. This program serves children ages 2 years to 5 years. This program operates Monday - Friday 7:45 AM - 2:15 PM. There were 35 children and 6 staff present when LPA and LPM arrived. The facility was observed to be within the license capacity and limitations. This facility is funded by the California Department of Education and operating under Title 5 staffing ratios. Criminal record clearance was not reviewed. However, per condition of employment with the Los Angeles Unified School District, all individual’s present have obtained a criminal record clearance or criminal record exemption. ---Page 1 of 4

NAME OF LICENSING PROGRAM MANAGER: Rita Ramos
NAME OF LICENSING PROGRAM ANALYST: Nathanael Mooberry
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 02/11/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/11/2026

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.

LIC809 (FAS) - (09/23)

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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: LASSEN ELEMENTARY SCHOOL PRESCHOOL	FACILITY NUMBER: 197402054
	VISIT DATE: 02/11/2026

NARRATIVE

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All areas identified on the facility sketch were toured both indoors and outdoors.

Furniture and equipment were inspected for age appropriateness and good repair. Telephone service, heating, lighting and ventilation were evaluated. Children have their own cubby to store their belongings. LPA and LPM did not observe children's belongings touching. Cots and linens are provided for each child enrolled. Linens are washed weekly by school district. LPA and LPM observed napping equipment stored in cabinets in each classroom. Age-appropriate sinks and toilets were inspected for availability and good repair in the restrooms. Each classroom also has an additional sink for handwashing. The facility has a total of 5 sinks and 2 toilets. General sanitation was observed. Availability of indoor drinking water was observed in classrooms. Per Principal, children bring their own water bottle daily and bottled water and filtered water stations are available for children who need water refills.

Disinfectants, cleaning solutions, medication and other items that are dangerous to children, were inaccessible to children. Per Plant Manager, poisons are locked in the Plant Manager's office with two locked doors. Carbon monoxide detectors were observed and are operable. Disaster drill log was available, last drill was conducted on 01/14/2026.

All kitchen areas/food preparation areas and food storage areas are kept clean and are free of litter, rubbish, rodents, and/or any other vermin. All storage containers for solid waste, including moveable bins shall have tight-fitting covers that are kept on, and in good repair. Trash cans used to discard food have tight fitting lids or solid waste bags shall be discarded immediately after each meal.

Menus are posted one month in advance where a QR code is visible by the child's authorized representative. The facility provides breakfast and lunch to children. Food is prepared in the main elementary cafeteria across from the facility. Meals are brought to the facility daily.

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NAME OF LICENSING PROGRAM MANAGER: Rita Ramos
NAME OF LICENSING PROGRAM ANALYST: Nathanael Mooberry
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 02/11/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/11/2026

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: LASSEN ELEMENTARY SCHOOL PRESCHOOL	FACILITY NUMBER: 197402054
	VISIT DATE: 02/11/2026

NARRATIVE

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Outdoor playground equipment is in a safe condition, free of sharp, loose or pointed parts. The surface of the outdoor activity space is maintained in a safe condition and is free of hazards. All areas around or under high climbing equipment, slides, and similar equipment are cushioned with material that absorbs a fall. There is adequate shade in the play yard. Availability of outdoor drinking water was observed. LPA advised that no children shall be left without the supervision of a teacher at any time.

All floors were observed to be clean and safe. All materials accessible to children were observed to be toxic-free. Per Principal, there are no firearms stored on the premises. LPA observed no pools or bodies of water at the facility.

Facility has conducted water lead testing to comply with Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018 requires all licensed Child Care Centers (CCC’s) constructed before January 1,2010 to test their drinking water for lead contamination between January 1, 2020 and January 1, 2023, and then every five years after the date of the first test.

LPA reviewed staff records. The review of Staff records was documented on the LIC 859. Staff present did not have proof of the AB 1207 Mandated Reporter Training certificate on file. Staff #1 present did have proof against TB, measles, pertussis, and influenza. There is at least one person trained in CPR and Pediatric First Aid present during this inspection.

Children’s Records were reviewed. Inspection of required forms was made and documented on the LIC 857. Children's roster was reviewed and is current. Sign-In and Sign-Out sheets were reviewed. Children present were signed in.

First Aid supplies were observed in each classroom. A first aid kit is also kept in the Nurse's office. According to the Principal, medication is only administered to a child when accompanied with a doctor's note and is stored in the Nurse's office.

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NAME OF LICENSING PROGRAM MANAGER: Rita Ramos
NAME OF LICENSING PROGRAM ANALYST: Nathanael Mooberry
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 02/11/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/11/2026

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: LASSEN ELEMENTARY SCHOOL PRESCHOOL	FACILITY NUMBER: 197402054
	VISIT DATE: 02/11/2026

NARRATIVE

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The facility was observed to be equipped with an isolation area located in the Nurse's office for any child who becomes ill.

This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see PIN 22-02-CCP. 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/.

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.

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

Deficiencies cited during today’s inspection are on the following LIC809-D Forms.

A notice of site visit was given and must remain posted for 30 days.
Exit interview conducted and report was reviewed with Uchenna Okereke, Principal.

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NAME OF LICENSING PROGRAM MANAGER: Rita Ramos
NAME OF LICENSING PROGRAM ANALYST: Nathanael Mooberry
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 02/11/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/11/2026

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 02/11/2026 02:54 PM - It Cannot Be Edited

Created By: Nathanael Mooberry On 02/11/2026 at 02:20 PM

Link to Parent Document Below:

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: LASSEN ELEMENTARY SCHOOL PRESCHOOL	FACILITY NUMBER: 197402054
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 02/11/2026

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1596.8662(b)(1)

Administration of Child Day Care Licensing

(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation and record review, the licensee did not comply with the section cited above in 1 out of 2 staff which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 02/25/2026
	Plan of Correction
1 2 3 4	Take training and provide LPA with a copy of the certificate and store in staff file by the POC date of 2/25/2026.

Type B

Section Cited

HSC

1596.7995(a)(1)

General Provisions and Definitions

(1) Commencing September 1, 2016, a person shall not be employed or volunteer at a day care center if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observationand record review, the licensee did not comply with the section cited above in 1 out of 2 staff which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 02/25/2026
	Plan of Correction
1 2 3 4	Provide LPA with a copy of the immunization record and store in staff file by the POC date of 2/25/2026.

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

	Rita Ramos
NAME OF LICENSING PROGRAM MANAGER:

	Nathanael Mooberry
NAME OF LICENSING PROGRAM ANALYST:

LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 02/11/2026

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/11/2026

LIC809 (FAS) - (06/04)

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