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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197418297
Report Date: 01/18/2024
Date Signed: 01/18/2024 11:32:56 AM

Document Has Been Signed on 01/18/2024 11:32 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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:BEL AIR PRESBYTERIAN CHURCH PRESCHOOLFACILITY NUMBER:
197418297
ADMINISTRATOR:JILLIAN MARSHFACILITY TYPE:
850
ADDRESS:16221 MULHOLLAND DRIVETELEPHONE:
(818) 990-6071
CITY:LOS ANGELESSTATE: CAZIP CODE:
90049
CAPACITY: 96TOTAL ENROLLED CHILDREN: 96CENSUS: 0DATE:
01/18/2024
TYPE OF VISIT:OfficeANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Jillian Marsh, DirectorTIME COMPLETED:
11:35 AM
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On 01/18/2024 Licensing Program Analyst (LPA) Laticia Thompson met with Jillian Marsh, Director. The purpose of the visit was to assist with missing documentation per Notice of Incomplete Application sent on 11/14/2023. LPA reviewed documents provided and made copies. Director will provide additional required documents as discussed by 1/26/2024 . LPA scheduled a prelicensing visit for 2/6/2024.
SUPERVISORS NAME: Deborah Lowe
LICENSING EVALUATOR NAME: Laticia S Thompson
LICENSING EVALUATOR SIGNATURE: DATE: 01/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/18/2024
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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