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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198020953
Report Date: 09/27/2024
Date Signed: 09/27/2024 02:50:47 PM

Document Has Been Signed on 09/27/2024 02:50 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
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:BRELLA HOLLYWOODFACILITY NUMBER:
198020953
ADMINISTRATOR/
DIRECTOR:		REBECCA KELLYFACILITY TYPE:
850
ADDRESS:909 N. ORANGE DR.TELEPHONE:
(213) 300-5962
CITY:LOS ANGELESSTATE: CAZIP CODE:
90038
CAPACITY: 45TOTAL ENROLLED CHILDREN: 50CENSUS: 19DATE:
09/27/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:25 PM
MET WITH:Director, Rebecca KellyTIME VISIT/
INSPECTION COMPLETED:
02:55 PM
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On September 27, 2024, Licensing Program Analyst (LPA) Staicy Perry conducted an unannounced case management inspection. Upon arrival LPA met with Director Rebecca Kelly. Director guided LPA on a tour of the facility. The purpose of the inspection was to obtain additional information from the facility regarding an incident reported to the regional office. Census was taken. LPA observed 19 children and 4 staff at the time of inspection. This is a preschool program and Hours of operation are M-F 8:00am-5:00pm.

The department received an incident report via email from this facility on 08/05/2024 for an incident that occurred at the facility on 08/02/2024 involving an incident requiring medical attention.

During the inspection LPA obtained documentation in the form of facility roster, personal report and other documents pertaining to the incident.

Based on the information that was verified during the inspection and the information on the incident report, LPA Perry determined that further investigation is needed at a subsequent date. No deficiencies are being cited during today’s inspection.

The notice of site inspection must remain posted for a period of 30 days during hours of operation. Failure to maintain posting will result in a civil penalty of $100.00 dollars.



Exit interview conducted with Director Rebecca Kelly and report provided. Appeal rights discussed and explained.
SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Staicy Perry
LICENSING EVALUATOR SIGNATURE: DATE: 09/27/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/27/2024
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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