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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 195700264
Report Date: 03/11/2025
Date Signed: 03/11/2025 03:08:28 PM

Document Has Been Signed on 03/11/2025 03:08 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:VOALA PUEBLO DE LOS NINOSFACILITY NUMBER:
195700264
ADMINISTRATOR/
DIRECTOR:		MARTHA PEREZFACILITY TYPE:
860
ADDRESS:11630 HESBY STTELEPHONE:
(818) 985-6255
CITY:NORTH HOLLYWOODSTATE: CAZIP CODE:
91601
CAPACITY: 28TOTAL ENROLLED CHILDREN: 28CENSUS: DATE:
03/11/2025
TYPE OF VISIT:OfficeANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:47 PM
MET WITH:Edie Smith, Area SupervisorTIME VISIT/
INSPECTION COMPLETED:
03:14 PM
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On 03/11/2025 LPA conducted an office visit with Edie Smith for the purpose of providing assistance with an Incomplete Application for an increase in capacity adding a School Age Component. The following was discussed:

Parent Handbook, Admissions Agreement, Facility Sketch, Waiver Request Letter, Preventative Health and Safety Practices with Lead component Certificate and Schedule of Activities (Preschool).



Facility Representative provided the following
An updated LIC 308 with the correct license number
An updated Parent Handbook and Admission Agreement (pending review)
An updated Facility Sketch
Proof of course enrollment for director to complete Lead Safety training.
Activity Schedules for Preschoolers and School Age Children.

LPA discussed waiver request and guidance. Facility will provide an updated outdoor waiver request by 03/14/2025.

Today LPA returned he following duplicate and not needed documents:
Felix Cruz (Directors Package) and Copy of current License,
SUPERVISORS NAME: Deborah Lowe
LICENSING EVALUATOR NAME: Laticia S Thompson
LICENSING EVALUATOR SIGNATURE: DATE: 03/11/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/11/2025
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: VOALA PUEBLO DE LOS NINOS
FACILITY NUMBER: 195700264
VISIT DATE: 03/11/2025
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Duplicate documents; LIC 500, LIC 308, Resolution, orientation certificate, Lead Testing Report, Mandated Reporter Certificate, Enrollment Procedures, Admission Agreement

The facility representative was provided a copy this report. Licensure is pending waiver request and Licensing Program Manager review.

SUPERVISORS NAME: Deborah Lowe
LICENSING EVALUATOR NAME: Laticia S Thompson
LICENSING EVALUATOR SIGNATURE:

DATE: 03/11/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/11/2025
LIC809 (FAS) - (06/04)
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