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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191202152
Report Date: 01/19/2023
Date Signed: 01/19/2023 03:32:39 PM

Document Has Been Signed on 01/19/2023 03:32 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:VALLEY BETH SHALOM NURSERY SCHOOLFACILITY NUMBER:
191202152
ADMINISTRATOR:ABBY MARSFACILITY TYPE:
850
ADDRESS:15739 VENTURA BOULEVARDTELEPHONE:
(818) 788-0567
CITY:ENCINOSTATE: CAZIP CODE:
91436
CAPACITY: 249TOTAL ENROLLED CHILDREN: 249CENSUS: 196DATE:
01/19/2023
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME BEGAN:
01:45 PM
MET WITH:Abigail Mars, ECC DirectorTIME COMPLETED:
04:00 PM
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On 01/19/2023 at 1:45 PM, Licensing Program Analysts (LPA) Sabrina Martinez and Lilia Hernandez conducted a Case Management- Lead Testing/ Exceedance visit. LPAs met with Renee Kalmanson, ECC Assistant Director, and discussed the purpose of the visit.

On 10/03/2022, LPA Thompson conducted a visit to address the lead exceedance of outlet “DD”.

During today’s visit, LPAs Martinez and Hernandez observed that outlet “DD” is a handwashing sink, and is not used for drinking or food preparation. LPAs also observed that children in care do not have access to outlet “DD”.

There were no deficiencies cited during today’s inspection.

A Notice of Site Visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with Abigail Mars, ECC Director.

SUPERVISORS NAME: Betty Bell
LICENSING EVALUATOR NAME: Sabrina Martinez
LICENSING EVALUATOR SIGNATURE: DATE: 01/19/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/19/2023
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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