<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197402655
Report Date: 10/22/2024
Date Signed: 10/22/2024 04:04:04 PM

Document Has Been Signed on 10/22/2024 04:04 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
L.A. DAYCARE-NO.WEST, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:UCLA EARLY CARE & EDUC. UNI. VILLAGE C.C.C.FACILITY NUMBER:
197402655
ADMINISTRATOR/
DIRECTOR:		NEGIN ZOMORODIFACILITY TYPE:
850
ADDRESS:3233 S SEPULVEDA BLVDTELEPHONE:
(310) 915-5827
CITY:LOS ANGELESSTATE: CAZIP CODE:
90034
CAPACITY: 90TOTAL ENROLLED CHILDREN: 90CENSUS: 60DATE:
10/22/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:15 PM
MET WITH:NEGIN ZOMORODI, LEAD DIRECTORTIME VISIT/
INSPECTION COMPLETED:
04:00 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 10/22/2024 Licensing Program Analyst (LPA) Lisa Clayton arrived at the Child Care Center unannounced, to conduct a Case Management – Incident visit. LPA Clayton was greeted by Director Negin “Nikki” Zomorodi. LPA Clayton observed 60 children in care being supervised and cared for by 10 fingerprint cleared staff.

LPA Clayton toured the facility outside and inside for a Health and Safety inspection. LPA Clayton reviewed the child’s file and documents of ongoing observations. LPA Clayton interviewed staff involved in the incident.

Description of the incident: RP reported that on 10/8/2024 the child #1 displayed inappropriate behavior and language with Center Coordinator. The child was removed from the classroom and taken outside and allowed to self-regulate (she rode a bicycle around the playground for ten minutes). Director Nikki and Admin Assistant Debbie helped C1 return to class where she took a nap with the assistance of Teacher Jane. The incident was reported to DCFS on 10/10/24. UIR was emailed to the Department on 10/10/2024. Director Kasey spoke to the parents when they picked the child up from school.

Incident update: The child is no longer enrolled at the CCC. Per Director Nikki the child’s last day was Friday October 18, 2024.

SUPERVISORS NAME: Karren Starks
LICENSING EVALUATOR NAME: Lisa Clayton
LICENSING EVALUATOR SIGNATURE: DATE: 10/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/22/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 2
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
L.A. DAYCARE-NO.WEST, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: UCLA EARLY CARE & EDUC. UNI. VILLAGE C.C.C.
FACILITY NUMBER: 197402655
VISIT DATE: 10/22/2024
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
26
27
28
29
30
31
32
Based on the information obtained, interviews conducted and LPA's observations the staff handled the incident in compliance with Title 22 Regulations and Health and Safety codes for Child Care Centers. In addition, the facility reported the unusual incident in a timely manner; therefore, no Title 22 violations have occurred, and no deficiencies are cited.

Exit interview conducted and report was reviewed with Director Nikki.

LPA Clayton posted Notice of Site visit which to the remain posted for 30 days.

SUPERVISORS NAME: Karren Starks
LICENSING EVALUATOR NAME: Lisa Clayton
LICENSING EVALUATOR SIGNATURE:

DATE: 10/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/22/2024
LIC809 (FAS) - (06/04)
Page: 2 of 2