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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197416694
Report Date: 01/22/2024
Date Signed: 01/22/2024 02:19:24 PM

Document Has Been Signed on 01/22/2024 02:19 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 NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:WASHINGTON PRIMARY CENTERFACILITY NUMBER:
197416694
ADMINISTRATOR:ALLISON SPEIGHTFACILITY TYPE:
850
ADDRESS:860 W. 112TH STREET RM K1 & K2TELEPHONE:
(323) 779-7550
CITY:LOS ANGELESSTATE: CAZIP CODE:
90044
CAPACITY: 48TOTAL ENROLLED CHILDREN: 48CENSUS: 8DATE:
01/22/2024
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
11:31 AM
MET WITH:Mary Seay, Principal TIME COMPLETED:
02:35 PM
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Licensing Program Analyst (LPA) Lilia Hernandez conducted an unannounced case management inspection on 01/22/2024. LPA arrived at the facility at 9:30AM and met with Mary Seay, Principal, who guided LPA on a tour of the facility. There were 8 children and 3 staff present upon arrival.

During an inspection on 12/12/2023, Principal disclosed that Room K-2 is being used as a universal transitional kindergarten classroom.(UTK)

Room K-1 is the only classroom used for state preschool and maximum enrollment is 16 children from ages 2.9 to 5 years old.

LPA Hernandez advised Principal that prior to construction or alterations, the licensee shall notify the Department of the proposed change(s).

Based on observation and record review, the facility did not notify the Department regarding the reduction of the facility's square footage.

California Code of Regulations, Title 22, Division 12, Chapter 1, 101237 Alterations to Existing Buildings or New Facilities is being cited on the attached LIC9099D.

The Notice of Site Visit was given and must remain posted for 30 days during the hours of operation after each site visit by a licensing representative.

Exit interview was conducted and report was reviewed with Mary Seay, Principal.
SUPERVISORS NAME: Rita Ramos
LICENSING EVALUATOR NAME: Lilia Hernandez
LICENSING EVALUATOR SIGNATURE: DATE: 01/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/22/2024
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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Document Has Been Signed on 01/22/2024 02:19 PM - It Cannot Be Edited


Created By: Lilia Hernandez On 01/22/2024 at 01:09 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: WASHINGTON PRIMARY CENTER
FACILITY NUMBER: 197416694

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/22/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/16/2024
Section Cited
CCR
101237

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Alterations to Existing Buildings or New Facilities (a) Prior to construction or alterations, the licensee shall notify the Department of the proposed change(s)...
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Principal will consult with Early Education Local District Director regarding the reduction of square footage. An LIC279 application with a detail statement noting changes will be submitted to the Department by POC due date.
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This requirement was not met as evidenced by observations and disclosures made indicating that Room K-2 is being used as a universal transitional kindergarten classroom.(UTK) Room K-1 is the only classroom used for state preschool which poses a potential health, safety or personal rights risk to persons in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Rita Ramos
LICENSING EVALUATOR NAME:Lilia Hernandez
LICENSING EVALUATOR SIGNATURE:
DATE: 01/22/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/22/2024


LIC809 (FAS) - (06/04)
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