Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197405979
Report Date: 07/19/2018
Date Signed: 07/19/2018 11:01:30 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:LES INFANTS INC. PRESCHOOLFACILITY NUMBER:
197405979
ADMINISTRATOR:NASRIN PAKIZEGIFACILITY TYPE:
850
ADDRESS:2702 VIRGINIA AVENUETELEPHONE:
(310) 315-0058
CITY:SANTA MONICASTATE: CAZIP CODE:
90404
CAPACITY:37CENSUS: 36DATE:
07/19/2018
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
08:15 AM
MET WITH:Nasrin Pakizegi, licenseeTIME COMPLETED:
09:15 AM
NARRATIVE
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Licensing Program Analyst (LPA) Sabrina Martinez conducted an inspection at the facility on 07/13/2018 for the purpose of investigating complaint control number 30-CC-20180514102946. During this inspection, Nasrin Pakizegi, licensee, refused for day care children to be interviewed.

The facility is cited a Type A citation in violation of Title 22 CCR:

101200 (b). Inspection Authority of the Department. The Department has the authority to interview children or staff without prior consent.

Upon receipt, licensee shall post the report for 30 days in addition to the Notice of Site Visit & provide copies of the licensing report to parents/guardians of children in care at the facility by the close of business the following day or the next day child returns to the facility. The same report must be provided to parents or guardians of children newly enrolled at the facility during the next 12 months & licensee will obtain a signed Acknowledgement of Licensing Reports (LIC 9224) from parent/guardian & place it in each child's file.



An exit interview was conducted and a copy of this report, appeal rights along with the notice of site visit was provided to Nasrin Pakizegi, licensee.
SUPERVISOR'S NAME: Sharalyn Jenkins-SweetenTELEPHONE: (424) 301-3054
LICENSING EVALUATOR NAME: Sabrina MartinezTELEPHONE: (424) 301-3059
LICENSING EVALUATOR SIGNATURE:

DATE: 07/19/2018
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/19/2018
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: LES INFANTS INC. PRESCHOOL
FACILITY NUMBER: 197405979
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/19/2018
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
07/20/2018
Section Cited
CCR
101200(b)
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Inspection Authority of the Department. The Department has the authority to interview children or staff without prior consent.

On 07/13/18, Nasrin Pakizegi, licensee, refused for day care children to be interviewed by LPA Martinez.
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The facility was provided with a copy of Title 22,Div 12, Chapter 1,Article 04. Enforcement Provisions, 101200. Inspection Authority of the Department. The licensee will review the above mentioned regulation. Moreover, Nasrin Pakizegi, licensee, will provide the
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Department with a written statement on how the facility will comply with this requirement by the POC due date 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: Sharalyn Jenkins-SweetenTELEPHONE: (424) 301-3054
LICENSING EVALUATOR NAME: Sabrina MartinezTELEPHONE: (424) 301-3059
LICENSING EVALUATOR SIGNATURE:

DATE: 07/19/2018
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/19/2018
LIC809 (FAS) - (06/04)
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