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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197409224
Report Date: 10/05/2021
Date Signed: 10/05/2021 02:37:09 PM

Document Has Been Signed on 10/05/2021 02:37 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:CHILD'S WORLD SCHOOL-INFANT & TODDLERFACILITY NUMBER:
197409224
ADMINISTRATOR:PRESSMAN, MELINDAFACILITY TYPE:
830
ADDRESS:5414 CAPISTRANO AVENUETELEPHONE:
(818) 224-4040
CITY:WOODLAND HILLSSTATE: CAZIP CODE:
91367
CAPACITY: 36TOTAL ENROLLED CHILDREN: 0CENSUS: 20DATE:
10/05/2021
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
01:35 PM
MET WITH:Catherine LevyTIME COMPLETED:
02:58 PM
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On 10/05/2021 Licensing Program Analyst (LPA) Laticia Thompson conducted an unannounced visit to process a Change in Director application. LPA met with applicant Catherine Levy. Upon review of records the following documents need corrections made:

LIC 200A Center Application (Capacity and all information must be related to the specific facility number)
LIC 501 Provide the original document with an original signature.
LIC 308 Provide the name of who will be designated to act as director in the absence of Catherine Levy.
LIC 9096 Evaluation of Director Qualifications.

Please submit this documentation to the El Segundo Regional office by 10/12/2021

An exit interview was conducted and a copy of this report was provided to the applicant Catherine Levy.
SUPERVISORS NAME: Peter Flores
LICENSING EVALUATOR NAME: Laticia S Thompson
LICENSING EVALUATOR SIGNATURE: DATE: 10/05/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/05/2021
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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