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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191601892
Report Date: 09/12/2025
Date Signed: 09/12/2025 03:07:23 PM

Document Has Been Signed on 09/12/2025 03:07 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 RO, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:GOOD SHEPHERD PRE-SCHOOLFACILITY NUMBER:
191601892
ADMINISTRATOR/
DIRECTOR:		RACHEL MARSHALLFACILITY TYPE:
850
ADDRESS:21100 VICTOR STTELEPHONE:
(310) 542-9829
CITY:TORRANCESTATE: CAZIP CODE:
90503
CAPACITY: 73TOTAL ENROLLED CHILDREN: 73CENSUS: 22DATE:
09/12/2025
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:25 AM
MET WITH:Rachel MarshallTIME VISIT/
INSPECTION COMPLETED:
03:20 PM
NARRATIVE
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On 09/12/2025, Licensing Program Analyst (LPA) Tyra Chavies conducted an unannounced case management- Lead Testing/ Exceedance visit. LPA met with director, Rachel Marshall. LPA informed director about the purpose of the visit and toured the facility. LPA observed 22 children being supervised by 6 staff members. Hours of operations are Monday-Friday 8:30 AM - 12:30 PM, optional lunch club from 12:30 PM - 2:30 PM.

The Purpose of today’s visit is to follow up lead testing results of Action Level Exceedances (ALE) and conduct an inspection. Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018 requires all CCCs located in buildings constructed before January 1, 2010, to test their drinking water for lead contamination between January 1, 2020, and January 1, 2023, and then every 5 years after the date of the first test. The CCC must also post the results by January 1, 2023, and every 5 years after the date of the initial test. For a license issued on or after. Community Care Licensing was notified that lead water testing conducted at the facility on November 10 2023, exceeded allowable limit for lead. Samples testing over 5.5 ppb/ug L and above is considered an exceedance.
NAME OF LICENSING PROGRAM MANAGER: Karren Starks
NAME OF LICENSING PROGRAM ANALYST: Tyra Chavies
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 09/12/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/12/2025
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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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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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
EL SEGUNDO CC RO, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: GOOD SHEPHERD PRE-SCHOOL
FACILITY NUMBER: 191601892
VISIT DATE: 09/12/2025
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During the inspection LPA Chavies received the following documents from facility: Lead Testing Results for 2023, which shows samples testing over 5.5 ppb/ug L. LPA was not able to confirm if the facility was able to fix the faucet over 5.5 ppb/ug L and was able to re test.

Per Title 22 Division 12 Chapter 1, Sub-chapter 5, this facility is receiving a Technical Violations . Please see LIC 9102.
 
An exit interview was conducted with director, this report was read and a copy issued.

A copy of this report was read and given to Director as well as LIC 9213 (Notice of Site Visit form.) LIC 9213 is required to be posted for 30 days.
NAME OF LICENSING PROGRAM MANAGER: Karren Starks
NAME OF LICENSING PROGRAM ANALYST: Tyra Chavies
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 09/12/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/12/2025
LIC809 (FAS) - (06/04)
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