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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197420046
Report Date: 11/06/2023
Date Signed: 11/06/2023 03:37:13 PM

Document Has Been Signed on 11/06/2023 03:37 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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:VAN NUYS PRESCHOOLFACILITY NUMBER:
197420046
ADMINISTRATOR:MOON, YOUNGSUNFACILITY TYPE:
850
ADDRESS:6260 TYRONE AVENUETELEPHONE:
(818) 849-6705
CITY:VAN NUYSSTATE: CAZIP CODE:
91401
CAPACITY: 60TOTAL ENROLLED CHILDREN: 45CENSUS: 29DATE:
11/06/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
10:08 AM
MET WITH:MOON, YOUNGSUN - DirectorTIME COMPLETED:
03:26 PM
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On 11/06/2023, Licensing Program Analyst (LPA) Suzette Ornelas conducted an unannounced visit for the purpose of investigating a complaint. LPA met with Director, MOON, YOUNGSUN and conducted a tour of the facility. LPA observed 29 children and 6 teachers in care.

During todays visit, LPA obtained further information for complaint associated to CONTROL NUMBER 58-CC-20230712135652. LPA conducted interviews.

Exit interview was conducted with This report shall be made available to the public upon request. LIC 9213 Notice of Site Visit was provided and required to be posted for 30 days.
SUPERVISORS NAME: Betty Bell
LICENSING EVALUATOR NAME: Suzette Ornelas
LICENSING EVALUATOR SIGNATURE: DATE: 11/06/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/06/2023
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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