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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191600175
Report Date: 09/25/2024
Date Signed: 09/25/2024 02:30:23 PM

Document Has Been Signed on 09/25/2024 02:30 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
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:COVENANT PRESBYTERIAN CHURCH PRESCHOOLFACILITY NUMBER:
191600175
ADMINISTRATOR/
DIRECTOR:		SULTAN, KATHLEENFACILITY TYPE:
850
ADDRESS:6323 WEST 80 STREETTELEPHONE:
(310) 670-5758
CITY:LOS ANGELESSTATE: CAZIP CODE:
90045
CAPACITY: 74TOTAL ENROLLED CHILDREN: 74CENSUS: 10DATE:
09/25/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:30 PM
MET WITH:Tori Leamy, Administrative AssistantTIME VISIT/
INSPECTION COMPLETED:
02:30 PM
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On 09/25/2024 Licensing Program Analyst (LPA) Judy Laureano conducted an unannounced case management inspection at the above-mentioned facility for the purpose of delivering an amended report that was originally generated on 07/30/2024.

LPA Laureano met with Tori Leamy Assistant and toured the facility and observed 10 children 1 staff providing care and supervision.

No deficiencies were cited during today’s inspection in accordance to the California Code of Regulations Title 22, Division 12, Chapter 1 and California Health and Safety Code.

Upon on receipt of this report, the Licensee shall post the Notice of Site Visit.
The Notice of Site Visit shall be posted for 30 consecutive days. Failure to maintain posting as required, will result in an immediate $100 civil penalty.

An exit interview was conducted, and report was reviewed with Tori Leamy. A copy of this report and appeal rights were discussed and left with the Licensee, whose signature on this form confirm receipt of these documents.

SUPERVISORS NAME: Claudia Escobedo
LICENSING EVALUATOR NAME: Judy Laureano
LICENSING EVALUATOR SIGNATURE: DATE: 09/25/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/25/2024
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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