197402429-3-24-2026-58-CC-AMOS-DSGTQR-20260324145621

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197402429
Report Date: 03/24/2026
Date Signed: 03/24/2026 02:57:06 PM

Document Has Been Signed on 03/24/2026 02:57 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:	SAINT PAUL'S FIRST LUTHERAN PRESCHOOL		FACILITY NUMBER:	197402429
ADMINISTRATOR/ DIRECTOR:	CYNTHIA CLENDENEN		FACILITY TYPE:	850
ADDRESS:	11330 MC CORMICK STREET		TELEPHONE:	(818) 763-2892
CITY:	NORTH HOLLYWOOD	STATE: CA	ZIP CODE:	91601
CAPACITY: 41	TOTAL ENROLLED CHILDREN: 30	CENSUS: 27	DATE:	03/24/2026
TYPE OF VISIT:	Required - 3 Year	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	10:00 AM
MET WITH:	Cynthia Clendenen		TIME VISIT/ INSPECTION COMPLETED:	03:10 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	On 3/24/2026, Licensing Program Analyst (LPA) Amelia Morales conducted an Unannounced Required- 3 Year inspection at the above facility. Upon arrival, LPA Morales was greeted and let into the facility by Director Cynthia Clendenen, who guided LPA on a tour of the facility. The LIC125 Entrance Checklist was provided to help facilitate the inspection. Facility is currently licensed for a capacity of 41 children. LPA observed 27 children and 3 staff present at the time of the visit. Children's roster was reviewed and is current. Facility operating hours are Monday through Friday 7:00 AM to 6:00 PM. The facility utilizes two classrooms. LPA observed teacher child ratios in compliance and staff have the required background clearances at this time. LPA inspected the sign in/out sheets located at the entrance of classroom 1; all children present were signed in. LPA observed the following postings in the main entrance of classroom #1: License, Preschool Daily Schedule, Personal Rights, Child Care Center Notification of Parents' Rights Poster, Emergency Disaster Plan and the Child Passenger Safety Law. The Disaster drill log was available; the last fire drill was conducted on 2/6/2026 and the last earthquake drill was run on 2/6/2026 as well. Page 1 of 4

NAME OF LICENSING PROGRAM MANAGER: Rita Ramos
NAME OF LICENSING PROGRAM ANALYST: Amelia Morales
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 03/24/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/24/2026

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: SAINT PAUL'S FIRST LUTHERAN PRESCHOOL	FACILITY NUMBER: 197402429
	VISIT DATE: 03/24/2026

NARRATIVE

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During the tour of the facility the following was observed: Furniture and equipment were inspected for age appropriateness and good repair. The classrooms were inspected to ensure that the floors have a surface that is safe and clean. LPA observed telephone service, heating, lighting and ventilation to be satisfactory. Children have adequate cubby storage for their belongings in each classroom. LPA observed napping equipment, cots are provided for each child enrolled. The sheets are laundered weekly by the parents.

Age appropriate restroom, sinks and toilets were inspected for good repair, toilet paper, safety and sanitation. All available toilets and sinks are in operable condition. General sanitation was observed. Per Director, children bring their own water bottle daily, that is labeled with child's name. LPA Morales observed a filtered water station inside classroom #1. Per Director teachers refill water bottles throughout the day for children.

There was one First Aid Kit in the restroom, which was completed. The isolation area is located in classroom #2 .

Disinfectants, cleaning solutions, medication and other items that are hazardous to children, were inaccessible to children. The facility is equipped with smoke detectors in each classrooms. LPA observed an operable carbon monoxide detector in the main office and located in each classroom area. LPA observed fire extinguishers (2A10BC) located in the classroom kitchen and is up to date.

Per Director, parents provide children's lunches, while the facility provides AM/PM snacks. 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.

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 playground. LPA advised that no children shall be left without the supervision of a teacher at any time.

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NAME OF LICENSING PROGRAM MANAGER: Rita Ramos
NAME OF LICENSING PROGRAM ANALYST: Amelia Morales
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 03/24/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/24/2026

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: SAINT PAUL'S FIRST LUTHERAN PRESCHOOL	FACILITY NUMBER: 197402429
	VISIT DATE: 03/24/2026

NARRATIVE

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All floors were observed to be clean and safe. All materials accessible to children were observed to be toxic-free. There are no pools or bodies of water at the facility. During staff file reviews, LPA Morales noted that the CPR and Pediatric First Aid present during this inspection the course was taken online. Per facility staff will complete certification and send via email to LPA Morales.

Five children’s files were reviewed. Inspection of required forms was made and documented on the LIC 857. All five files were contained the required forms. LPA also reviewed staff records. The review of Staff records was documented on the LIC 859. Staff present did not have the correct of the AB 1207 Mandated Reporter Training certificate on file. Per facility, they will send LPA Morales the correct certification. Staff present did have proof against TB, measles, pertussis, and influenza.

CCC 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 as specified in Health and Safety Code section 1597.16.

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.).

LPA verified that the lead testing was completed in accordance to the Written Directives (Interim Licensing Standards) outlined in PIN 21-21.1-CCP.

LPA referred licensee [or facility representative] to the Department website for lead: Lead Toxicity Prevention and Water Testing Information (https://www.cdss.ca.gov/inforesources/child-care-licensing/water-testing-information)

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NAME OF LICENSING PROGRAM MANAGER: Rita Ramos
NAME OF LICENSING PROGRAM ANALYST: Amelia Morales
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 03/24/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/24/2026

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: SAINT PAUL'S FIRST LUTHERAN PRESCHOOL	FACILITY NUMBER: 197402429
	VISIT DATE: 03/24/2026

NARRATIVE

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CCC COMPLETED TESTING AND NO LEAD EXCEEDANCES

CCC Licensee [or facility representative] 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.

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/.

Licensee [or facility representative] 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.

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.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the Director Cynthia Clendenen.

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NAME OF LICENSING PROGRAM MANAGER: Rita Ramos
NAME OF LICENSING PROGRAM ANALYST: Amelia Morales
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 03/24/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/24/2026

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 03/24/2026 02:57 PM - It Cannot Be Edited

Created By: Amelia Morales On 03/24/2026 at 02:02 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: SAINT PAUL'S FIRST LUTHERAN PRESCHOOL	FACILITY NUMBER: 197402429
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 03/24/2026

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 interview,record review, the licensee did not comply with the section cited above in 4 out of 4 staff did not have the correct Mandated Reporter certfication which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 04/14/2026
	Plan of Correction
1 2 3 4	Per Director, certification will be taken and certifications will be emailed to LPA Morales by POC date.

Type B

Section Cited

CCR

101216(f)

Personnel Requirements

(f) At least one staff member who is trained in pediatric cardiopulmonary resuscitation and pediatric first aid pursuant to Health and Safety Code Section 1596.866 shall be present when children are at the child care center or offsite for center activities. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on interview, record review, the licensee did not comply with the section cited above in 4 out of 4 staff CPR & Pediatric First Aid that the certifications taken were taken online, which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 04/14/2026
	Plan of Correction
1 2 3 4	Per Director, certification will be taken and certifications will be emailed to LPA Morales by POC date.

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:

	Amelia Morales
NAME OF LICENSING PROGRAM ANALYST:

LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 03/24/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/24/2026

LIC809 (FAS) - (06/04)

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