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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197494727
Report Date: 12/07/2022
Date Signed: 12/07/2022 04:59:28 PM

Document Has Been Signed on 12/07/2022 04:59 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:BUMO - CENTURY CITYFACILITY NUMBER:
197494727
ADMINISTRATOR:LAUREN LOVOY-GRANADOSFACILITY TYPE:
850
ADDRESS:10250 SANTA MONICA BLVD. #2860TELEPHONE:
9096486954
CITY:LOS ANGELESSTATE: CAZIP CODE:
90067
CAPACITY: 14TOTAL ENROLLED CHILDREN: 58CENSUS: 10DATE:
12/07/2022
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
04:01 PM
MET WITH:Malia Swartz, Director Assistant OperationalTIME COMPLETED:
04:30 PM
NARRATIVE
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On 12/07/2022, Licensing Program Analyst (LPA) Denise Miranda conducted a Case Management- Deficiencies visit for the purpose of citing for the deficiencies that were observed during the visit on 12/07/2022.

LPA met with Malia Swartz, Director Assistant Operational. There were 10 children in care being supervised by 2 staff.

Based on observation, and record review and interviews, facility does not have a Director since 01/2022 and facility did not designated a facility responsibility. Facility was unable to produce copy of the form lic308 Designation of Facility Responsibility.



Per Title 22, Division 12, Chapter 6, of the California Code of Regulations, the following deficiencies is being cited: (see next page, 809 D)

An exit interview was conducted and a copy of this report, appeal rights and Notice of Site Visit was provided to Malia Swartz, Director Assistant Operational.


SUPERVISORS NAME: Rita Ramos
LICENSING EVALUATOR NAME: Denise Miranda
LICENSING EVALUATOR SIGNATURE: DATE: 12/07/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/07/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 2
Document Has Been Signed on 12/07/2022 04:59 PM - It Cannot Be Edited


Created By: Denise Miranda On 12/07/2022 at 04:07 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: BUMO - CENTURY CITY
FACILITY NUMBER: 197494727

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/07/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
12/27/2022
Section Cited
CCR
101215.1(b)

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101215.1 Child Care Center Directors Qualifications and Duties : (b) All child care centers shall have a director. This This requirement is not met as evidenced by:
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Facility will submit to LPA documents to qualify a new Director no later than 12/27/2022. LPA provided a list of documents to qualify a new Director.
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12/7/2022, based on interview, file review, facility does not have a Director since 01/22.
This poses a potential H&S to children in care.
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The Documents will be mail to El Segundo Regional Office. LPA provided a business card with the office's address.
Type B
12/27/2022
Section Cited
CCR101215.(f)

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101215.1 (f) Child Care Center Director Qualification and Duties (f) ....shall be designated as an authorized person to correct operational deficiencies that constitute immediate threats to children's health and safety.
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Facility wil submit via mail lic308 Designation of Facility Responsability form with staff transcript via mail no later than 12/27/2022.
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This is not met as evidence by 12/7/2022, based on interivew, file review and observation, facility does not have a designate person of facility responsability. Facility was unable to provide form lic308. This poses a potential H& S to children 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:Denise Miranda
LICENSING EVALUATOR SIGNATURE:
DATE: 12/07/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/07/2022


LIC809 (FAS) - (06/04)
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