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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197494783
Report Date: 09/29/2023
Date Signed: 09/29/2023 11:48:19 AM

Document Has Been Signed on 09/29/2023 11:48 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:NEW GENERATION LE PETITFACILITY NUMBER:
197494783
ADMINISTRATOR:ZAHRA HADDADIFACILITY TYPE:
830
ADDRESS:11538 VICTORY BLVDTELEPHONE:
(818) 269-6369
CITY:NORTH HOLLYWOODSTATE: CAZIP CODE:
91606
CAPACITY: 29TOTAL ENROLLED CHILDREN: 29CENSUS: 12DATE:
09/29/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Zahra Haddadi, DirectorTIME COMPLETED:
11:50 AM
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On 09/29/23 at 9:00 AM, Silva Garibyan, Licensing Program Analyst (LPA), conducted an unannounced Annual Required Inspection. LPA met with Zahra Haddadi, Director and toured the facility. During today’s visit LPA observed for staff providing care and supervision to 12 children. LPA verified facility phone number is 818-824-3655.

Due to time constraints the Annual visit will be completed on a future date.

A copy of this Report, Notice of Site Visit, and Appeal rights where explained and provided to the Director Zahra Haddadi.

SUPERVISORS NAME: Betty Bell
LICENSING EVALUATOR NAME: Silva Garibyan
LICENSING EVALUATOR SIGNATURE: DATE: 09/29/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/29/2023
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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