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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197414042
Report Date: 04/22/2026
Date Signed: 04/22/2026 10:58:49 AM

Document Has Been Signed on 04/22/2026 10:58 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 RO, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:CCRC HEAD START - SEPULVEDAFACILITY NUMBER:
197414042
ADMINISTRATOR/
DIRECTOR:		FIDES-LEAH SOTOFACILITY TYPE:
850
ADDRESS:15435 RAYEN STREETTELEPHONE:
(818) 892-0728
CITY:SEPULVEDASTATE: CAZIP CODE:
91343
CAPACITY: 54TOTAL ENROLLED CHILDREN: 47CENSUS: 40DATE:
04/22/2026
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:00 AM
MET WITH:Director, Teresa RamosTIME VISIT/
INSPECTION COMPLETED:
11:35 AM
NARRATIVE
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On April 22, 2026 at approximately 9:00am, Licensing Program Analyst (LPA) Melissa Zaragoza conducted a unannounced, case management visit to CCRC Head Start Sepulveda. LPA Zaragoza is conducting a visit regarding 2 UIRs that occurred on March 04, 2026, and April 06, 2026. LPA met with director, Teresa Ramos, and explained the purpose of the visit. Present during LPA's visit included 12 teaching staff and 40 children present. Facility is operating within capacity limits and ratio during LPA's visit. Teaching staff present have criminal record clearance on file through Child Care Resource Center. Childcare centers hours of operation are Monday through Friday from 7:30am to 5:30pm.

On March 04, 2026, C1 was running and hit themselves on a pole, resulting in a small cut on the top, left side of their head. Per director, they interviewed C1 and C1 stated, “they were running and got hit”. The facility applied first aid, an ice pack, and cleaned the wounded area. Per director, they immediately called C1's parent, and notified their superior of C1s head injury, the Health Department, and Child Care Licensing. Per director, they also provided C1s mother with an Ouch Report.

Per director, C1’s mother arrived at the facility to pick them up and took C1 home. Mother of C1 monitored C1 at home and then decided to take them to the emergency room. Per mother of C1, C1 received glue on wound to close it and was advised to be monitored. Per director, C1 was out the next day, and returned on March 6, 2026. Once C1 returned, mother requested the childcare center to monitor them. Per director, C1 had to restrictions returning to the childcare center. During LPAs visit LPA observed C1 back in class, and the outdoor play area where the incident occurred.

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NAME OF LICENSING PROGRAM MANAGER: Rita Ramos
NAME OF LICENSING PROGRAM ANALYST: Melissa Zaragoza
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 04/22/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/22/2026
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: CCRC HEAD START - SEPULVEDA
FACILITY NUMBER: 197414042
VISIT DATE: 04/22/2026
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On April 06, 2026, the director was notified by S1 that the play areas was unleveled, concrete floor had sunk, and the pavement was uneven. Per director, uneven pavement looked normal but once you got close, and felt the floor, it felt uneven. Per director, after they noticed it, they immediately took action and let their supervisor know, and the maintenance staff. Per director, they called maintenance supervisors, and maintenance staff were advised to look at that flooring. Per director, maintenance staff put a table on top of the uneven pavement with caution tape around it, closing it off, and making it inaccessible to children. While pavement was off limits children were supervised by staff members so children would play around off limit area. Per director, staff were required to stand in a zone area to supervise children while they played outside.

The center's supervisor and manager then had a meeting and maintenance supervisor agreed to fix the floor over the weekend, when no children are present. On today’s date, LPA observed uneven pavement area to be fixed. Floor area was observed to be covered with new asphalt, and evenly flat.

There are no deficiencies issued during today’s visit. Appeal rights were provided.



A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the director, Teresa Ramos.
NAME OF LICENSING PROGRAM MANAGER: Rita Ramos
NAME OF LICENSING PROGRAM ANALYST: Melissa Zaragoza
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 04/22/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/22/2026
LIC809 (FAS) - (06/04)
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