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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191600604
Report Date: 09/07/2021
Date Signed: 09/08/2021 02:04:43 PM

Document Has Been Signed on 09/08/2021 02:04 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:ROLLING HILLS UNITED METHODIST CHURCH PRE-SCHOOLFACILITY NUMBER:
191600604
ADMINISTRATOR:GHABRIAL, MERVATFACILITY TYPE:
850
ADDRESS:26438 CRENSHAW BLTELEPHONE:
(310) 377-0742
CITY:ROLLING HILLS ESTATESTATE: CAZIP CODE:
90274
CAPACITY: 146TOTAL ENROLLED CHILDREN: 0CENSUS: 26DATE:
09/07/2021
TYPE OF VISIT:Case Management - Licensee InitiatedANNOUNCEDTIME BEGAN:
10:29 AM
MET WITH:M. Ghabrial & G.PalaciosTIME COMPLETED:
01:30 PM
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On 9/7/2021 Licensing Program Analyst (LPA) Jillinda Chandler met with directors Myra Ghabrial (RHUM Prescool) and Gaby Palacios (RHUM Kid Zone). The preschool program is requesting an increase in capacity from 146 to 174, the program plans to accomplish the increase by adding classrooms 202 and 201; currently assigned to Kid Zone license # 197409233.

The classrooms are located on the second level of the building and will only be used by the preschools 4 years and above students. The program shall provide a waiver request for the children in these classes to use the upstairs restrooms during the hours when the after school program is not in session. Children shall not commingle with the after school program at anytime.

The classroom were measured and shall be deducted from the school age program.
measurements = 942.95 divided by 35 SQ. FT. = 26 children. No more than 13 children per classroom.

Director Palacios was informed that there needs to be a decrease in capacity to the after school program and a new application with a twenty five dollar processing fee should be submitted to the regional office prior

Based on todays inspection the capacity shall be increased by 26 determined by indoor activity space for a total capacity of 172.
SUPERVISORS NAME: Peter Flores
LICENSING EVALUATOR NAME: Jillinda Chandler
LICENSING EVALUATOR SIGNATURE: DATE: 09/07/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/07/2021
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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