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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197402633
Report Date: 08/27/2025
Date Signed: 08/28/2025 01:03:31 PM

Document Has Been Signed on 08/28/2025 01:03 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 RO, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:WILSHIRE BOULEVARD TEMPLEFACILITY NUMBER:
197402633
ADMINISTRATOR/
DIRECTOR:		AMY LEIBOVITCHFACILITY TYPE:
850
ADDRESS:11661 W. OLYMPIC BLVD.TELEPHONE:
(424) 208-8900
CITY:LOS ANGELESSTATE: CAZIP CODE:
90064
CAPACITY: 242TOTAL ENROLLED CHILDREN: 242CENSUS: 0DATE:
08/27/2025
TYPE OF VISIT:Case Management - Licensee InitiatedANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:05 AM
MET WITH:Amy LeibovitchTIME VISIT/
INSPECTION COMPLETED:
02:30 PM
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On 08/27/2025, Licensing Program Analysts (LPA) Judy Laureano and Brittany Lovest made an announced visit at the above mentioned facility for the purpose of conducting a case management inspection. LPAs were greeted by facility director Amy Leibovitch who provided a tour of the facility according to the facility sketch provided.

LPAs did not observed any children in care during today’s inspection.

The facility is requesting to decrease their preschool capacity and will be eliminating the Toddler Component serving children ages 18 months to 36 months.

LPAs toured the on-limits areas and classrooms located at the facility to ensure that no major changes have been made that would impact capacity. The facility has a total of 16 classrooms.

The toddler option room is Room 175 also known as the Rotunda. Facility is requesting to eliminate Room 175 and use it as a preschool classroom.

The classroom, Room 175, measures 664.25 divided by 35 sq. ft = 18 children.

The applicant is requesting to serve a total of 226 preschool age children (2 years old through entry to 1st Grade). Facility is requesting to eliminate the Toddler Component/Option and transition the space, Room 175 for preschool use.

Childcare days are Monday – Thursday, 7:45 A.M. – 5:00 P.M. and Fridays, 7:45 A.M.- 3:15 P.M. There is an approved fire clearance on file conducted on 7/29/25 by Inspector Escalante of the LA City Fire Department.

NAME OF LICENSING PROGRAM MANAGER: Loyce Phillips
NAME OF LICENSING PROGRAM ANALYST: Judy Laureano
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 08/27/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/27/2025
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 RO, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: WILSHIRE BOULEVARD TEMPLE
FACILITY NUMBER: 197402633
VISIT DATE: 08/27/2025
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Indoor Activity Space
Fire extinguishers were 3A40BC or larger were observed. Smoke detector and carbon monoxide were observed in space. Facility was observed with a centralized sprinkler system. The required postings were posted in a prominent area for parents and visitor's view. Age-appropriate furniture and equipment was observed in good repair. LPAs observed age-appropriate toys and furniture. Each classroom was observed with a sink and water outlet/fountain.

The facility has central heating and cooling. Windows were in good repair free of chipping paint, dirt, insects, or debris. Adequate lighting was observed. The classrooms were clean in good repair.

Preschool rooms are 101, 102, 103, 104, 115, 118, 120, 121, 122, 124, 125, 126, 127 with the addition of the Saffro room and 175. LPAs observed and measured the Saffro room due to facility converting the space to one room.

Total indoor space, as of 8/27/2025:
Saffro Room and existing preschool classrooms measures 7295.7511 square feet divide by 35 square feet= 208 preschool children.

Room 175/Rotunda Room measures 664.25 square feet divided by 35 square feet= 18 preschool children.

Restrooms:
Children will have access to 28 sinks and 22 toilets.

Outdoor Activity Space:

LPAs observed and inspected 4 outdoor play areas. Shaded rest area for the children was observed. LPAs observed the outdoor areas to be free of hazards including, but not limited to, holes, broken glass and other debris, and dry grasses that pose a fire hazard. LPAs observed the areas around and under high climbing equipment and slides and other similar equipment shall be cushioned with material that absorbs falls.

No bodies of water were observed at facility. There shall be at least 75 square feet per child of outdoor activity space based on the total licensed capacity.

Based upon today’s inspection the facility shall be recommended for a maximum capacity of 226 preschool age children ( 2 years old through entry to First Grade)

An exit interview was conducted, copy of this report was discussed and provided to Director Amy Leibovitch.

NAME OF LICENSING PROGRAM MANAGER: Loyce Phillips
NAME OF LICENSING PROGRAM ANALYST: Judy Laureano
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 08/27/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/27/2025
LIC809 (FAS) - (06/04)
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