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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197494621
Report Date: 12/14/2022
Date Signed: 12/14/2022 03:53:37 PM

Document Has Been Signed on 12/14/2022 03:53 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:OAK TREE- VIEW PARK WINDSOR HILLSFACILITY NUMBER:
197494621
ADMINISTRATOR:OLUBUKOLA SALAKOFACILITY TYPE:
850
ADDRESS:4416 W. SLAUSON AVENUETELEPHONE:
(323) 815-1093
CITY:LOS ANGELESSTATE: CAZIP CODE:
90043
CAPACITY: 49TOTAL ENROLLED CHILDREN: 49CENSUS: DATE:
12/14/2022
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
01:47 PM
MET WITH:Shantil AlexanderTIME COMPLETED:
03:55 PM
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On 12/14/2022 Licensing Program Analyst ( LPA) Doris Whitmore conducted an unannounced Case Management- Incident Inspection for the purpose of following up on an Unususal Incident Report (UIR) submitted 04/29/2022. LPA met with Michelle Lundancy Compliance Manager,who toured with the LPA the facility inside and outside. LPA observed 22 children in care and 6 staff. LPA also met with with current Director Shantil Alexander.According to the UIR, on 04/29/2022 Child#1 bit Child#2. The two teachers in the classroom worked at different times. Child#1 was not picked up until after 5:00p.m.

During this visit LPA reviewed Child#1 file and obtained the following documents: Sign in Sheet for 04/29/2022, Staff Attendance Sheet, Rules of Conduct,& Biting Policy, Personnel Report, LPA discussed Biting Policy with Director. Staff members involved no longer work at facility. Based on inspection & interviews there are no citations or violations. Acopy of this report (LIC809) and Notice of of Site Visit was provided to the Director Shantil Alexander.



SUPERVISORS NAME: Karren Starks
LICENSING EVALUATOR NAME: Doris Whitmore
LICENSING EVALUATOR SIGNATURE: DATE: 12/14/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/14/2022
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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