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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197403097
Report Date: 10/19/2023
Date Signed: 10/19/2023 11:10:09 AM

Document Has Been Signed on 10/19/2023 11:10 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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:SYDNEY M. IRMAS CHILD CARE CENTERFACILITY NUMBER:
197403097
ADMINISTRATOR:BROCKNER, MONICAFACILITY TYPE:
850
ADDRESS:7446 ALABAMA STREETTELEPHONE:
(818) 348-2867
CITY:CANOGA PARKSTATE: CAZIP CODE:
91303
CAPACITY: 24TOTAL ENROLLED CHILDREN: 24CENSUS: 17DATE:
10/19/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
10:49 AM
MET WITH:Jacqueline SylvestreTIME COMPLETED:
11:15 AM
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On 10/19/23 Licensing Program Analyst (LPA) Maria Rendon made an unannounced visit for the purpose of capturing signatures on an amended report which was given on 9/14/2023. LPA met with Site Supervisor Jacqueline Sylvestre and explained the purpose of the visit. LPA observed 17 children under the care of 6 staff members.

There were no deficiencies cited on this day.

LP conducted an exit interview with Site Supervisor Jacqueline Sylvestre and a copy of this report, Notice of Site visit, and Appeal Rights were provided to Site Supervisor Jacqueline Sylvestre.

SUPERVISORS NAME: Rita Ramos
LICENSING EVALUATOR NAME: Maria Rendon
LICENSING EVALUATOR SIGNATURE: DATE: 10/19/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/19/2023
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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