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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197494026
Report Date: 12/14/2023
Date Signed: 12/14/2023 03:34:23 PM

Document Has Been Signed on 12/14/2023 03:34 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 RO, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:SHIRAYURI YOUCHIENFACILITY NUMBER:
197494026
ADMINISTRATOR:AOYAMA,YOSHIOFACILITY TYPE:
830
ADDRESS:20706 NORMANDIE AVENUETELEPHONE:
(310) 530-5830
CITY:TORRANCESTATE: CAZIP CODE:
90502
CAPACITY: 10TOTAL ENROLLED CHILDREN: 10CENSUS: DATE:
12/14/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
02:35 PM
MET WITH:Tomi Aoyama - AdministratorTIME COMPLETED:
03:40 PM
NARRATIVE
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On 12/14/2023, Licensing Program Analysts (LPA) Cristina Castellanos conducted an
unannounced annual inspection at Facility No. 197420084, found in the same premises as the facility named above. Upon arrival LPA met with administrator Tomi Aoyama and discussed the purpose of the visit. LPA toured the facility inside and outside and observed 10 children, and 3 staff members during today’s visit.

During the inspection, LPA observed 10 children and three staff members providing care and supervision for children in the Preschool/Toddler playground. As the children return to their designated classrooms LPA observed 4 out of the 10 children were taken into the infant classroom. LPA asked Administrator Tomi Aoyama why the four children, who were in the Toddler playground were now going into the infant classroom? Administrator Tomi Aoyama informed LPA that when there are not that many children present in either classroom, they join them together. LPA informed administrators Tomi and James that per regulation 101438.2(b) Outdoor activity space shall be physically separate from space used by children in the child care center and school-age child care center components.

Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, there was one (1) deficiency cited at this time for violation of Title 22 regulation; (see LIC809-D).

An exit interview was conducted and Plans of Correction were reviewed and developed with Administrators. A copy of this report and appeal rights were discussed and left with administrators Tomi Aoyama and James Aoyama. A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

SUPERVISORS NAME: Claudia Escobedo
LICENSING EVALUATOR NAME: Cristina Castellanos
LICENSING EVALUATOR SIGNATURE: DATE: 12/14/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/14/2023
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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Document Has Been Signed on 12/14/2023 03:34 PM - It Cannot Be Edited


Created By: Cristina Castellanos On 12/14/2023 at 02:54 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: SHIRAYURI YOUCHIEN
FACILITY NUMBER: 197494026

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/14/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
12/26/2023
Section Cited
CCR
101438.2(b)

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101438.2 Outdoor Activity Space for Infants
(b) Outdoor activity space shall be physically separate from space used by children in the child care center and school-age child care center components.
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Licensee agrees to retrain all staff on what a pre-school license and infant license is. Agrees to submit a set schedule for outdoor play time for infants in their designated area. Additionally will have each staff member signed the set schedule and submit it to LPA via email.

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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:Claudia Escobedo
LICENSING EVALUATOR NAME:Cristina Castellanos
LICENSING EVALUATOR SIGNATURE:
DATE: 12/14/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/14/2023


LIC809 (FAS) - (06/04)
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