<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197402051
Report Date: 05/26/2022
Date Signed: 05/26/2022 10:09:22 AM

Document Has Been Signed on 05/26/2022 10:09 AM - 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:AMESTOY ELEMENTARY SCHOOL ROOM 21FACILITY NUMBER:
197402051
ADMINISTRATOR:RYAN, HUGHFACILITY TYPE:
850
ADDRESS:1048 W. 149TH STREETTELEPHONE:
(310) 327-5592
CITY:GARDENASTATE: CAZIP CODE:
90247
CAPACITY: 24TOTAL ENROLLED CHILDREN: 24CENSUS: 14DATE:
05/26/2022
TYPE OF VISIT:Case Management - Annual ContinuationUNANNOUNCEDTIME BEGAN:
08:08 AM
MET WITH:Ashley Johnson & Alyma ReynaTIME COMPLETED:
10:00 AM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
On 5/26/ 2022 7:30a.m. Licensing Program Analyst (LPA) Doris Whitmore, conducted an unannounced Case Management Annual Continuation Inspection. LPA met with the Lead Teacher Ashley Johnson. LPA observed 14 children in care. Lead Teacher shared with LPA the children files along with the staff files are located in the central office. LPA Whitmore reviewed a total of 13 files. Some of the files were missing Personal Rights and Notification of Parents Rights files. LPA spoke with the School Administrator Assistant Alyma Reyna to discuss the missing forms. LPA Whitmore shared with the the School Administrator the website www. ccld.ca.gov and guided her through the website. LPA encouraged the School Administrator to go to the website to read Child Care quarterly updates to stay informed of any changes or updates to the regulations. LPA also gave the phone number to the El Segundo Regional Office.

An exit interview was conducted, and report was reviewed with School Administrator Alyma Reyna copy of this report (LIC 809), Notice of Site Visit, along with appeal rights were given to the School Administrator Alyma Reyna.

SUPERVISORS NAME: Claudia Escobedo
LICENSING EVALUATOR NAME: Doris Whitmore
LICENSING EVALUATOR SIGNATURE: DATE: 05/26/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/26/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 1