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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197410785
Report Date: 10/02/2024
Date Signed: 10/02/2024 10:02:36 AM

Document Has Been Signed on 10/02/2024 10:02 AM - 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:PACE - ST. JOHN HEAD START CENTERFACILITY NUMBER:
197410785
ADMINISTRATOR/
DIRECTOR:		LYDIA VARGASFACILITY TYPE:
850
ADDRESS:14517 CRENSHAW BLVD.TELEPHONE:
(424) 456-4889
CITY:GARDENASTATE: CAZIP CODE:
90249
CAPACITY: 45TOTAL ENROLLED CHILDREN: 39CENSUS: 24DATE:
10/02/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:39 AM
MET WITH: Debbie Khawaji- Regional Site DirectorTIME VISIT/
INSPECTION COMPLETED:
10:10 AM
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On 10/2/2024 at 8:39 a.m. Licensing Program Analyst (LPA)Doris Whitmore conducted an unannounced visit for conducting a Case Management Inspection due to an incident that occurred on 08/30/2024 and was reported to the Regional Office on 09/10/2024. LPA met with Debbie Kahwaji, Regional Site Supervisor and informed the nature of the visit. At the time of the visit there was only 24 children and 5 teacher's. LPA Whitmore interviewed S2 who was at PACE ALOHA the day of the incident on 08/30/2024

Based on the information obtained there are no deficiencies a copy of the report,appeal rights, and Notice of Site Visit was issued to Debbie Kahwaji.

SUPERVISORS NAME: Karren Starks
LICENSING EVALUATOR NAME: Doris Whitmore
LICENSING EVALUATOR SIGNATURE: DATE: 10/02/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/02/2024
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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