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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197402633
Report Date: 05/22/2024
Date Signed: 05/22/2024 12:33:37 PM

Document Has Been Signed on 05/22/2024 12:33 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
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:WILSHIRE BOULEVARD TEMPLEFACILITY NUMBER:
197402633
ADMINISTRATOR/
DIRECTOR:		CAROL BOVILLFACILITY TYPE:
850
ADDRESS:11661 W. OLYMPIC BLVD.TELEPHONE:
(424) 208-8900
CITY:LOS ANGELESSTATE: CAZIP CODE:
90064
CAPACITY: 242TOTAL ENROLLED CHILDREN: 242CENSUS: 175DATE:
05/22/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:00 AM
MET WITH:Amy Leibovitch, Assistant DirectorTIME VISIT/
INSPECTION COMPLETED:
12:30 PM
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On 5/22/2024 Licensing Program Analyst (LPA) Judy Laureano conducted a Case Management inspection at above mentioned facility to confirmed receipt of Decision and Order for lifetime exclusion. LPA Laureano was greeted by Assistant Director Amy Leibovitch who guided LPA on a facility tour. Present during today's inspection, Felisa Felsenthal Registrar of the Early Childhood Centers.

LPA observed the following:
Room 101- 13 children and 2 staff members
Room 102- 4 children and 2 staff members
Room 127- 13 children and 2 staff members
Room 126- Classroom was empty
Room 125- 14 children and 2 staff members
Room 124- 16 children and 3 staff members
Room 103- 16 children and 3 staff members
Room 122- 16 children and 3 staff members
Room 121- 11 children and 2 staff members
Room 104- 14 children and 2 staff members
Room 120- 14 children and 2 staff members
Room 118- 14 children and 2 staff members
Room 115- 13 children and 2 staff members
Room 175- 17 children and 4 staff members* Toddler Classroom

Assistant Director confirmed with facility’s Human Resources that individual is not a current employee. facility indeed received the Decision and Order LPA provided licensee a copy of Decision and Order dated February 08, 2024 with effective date of February 19, 2024. LPA reviewed the Order set forth by the Judge with Assistant Director A. Leibovitch. and Felisa Felsenthal Registrar of the early childhood centers.



Copy of this report and Notice of Site Visit (LIC 9213) was provided.
SUPERVISORS NAME: Claudia Escobedo
LICENSING EVALUATOR NAME: Judy Laureano
LICENSING EVALUATOR SIGNATURE: DATE: 05/01/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/01/2024
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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