197414470-9-10-2026-58-CC-TBIM-DXSTHM-20260910144458

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197414470
Report Date: 09/10/2026
Date Signed: 09/10/2026 02:45:34 PM

Document Has Been Signed on 09/10/2026 02:45 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:	SHEPHERD OF THE VALLEY LUTHERAN CHURCH		FACILITY NUMBER:	197414470
ADMINISTRATOR/ DIRECTOR:	SEASON ENG		FACILITY TYPE:	850
ADDRESS:	23838 KITTRIDGE STREET		TELEPHONE:	(818) 347-6784
CITY:	WEST HILLS	STATE: CA	ZIP CODE:	91307
CAPACITY: 104	TOTAL ENROLLED CHILDREN: 40	CENSUS: 29	DATE:	09/10/2026
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	09:20 AM
MET WITH:	Maria Goldman		TIME VISIT/ INSPECTION COMPLETED:	03:00 PM

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Licensing Program Analyst (LPA) Tatiana Bickham conducted an unannounced random annual inspection on 09/10/2026. LPA arrived at the facility at 9:20 AM. LPA met with Director Maria Goldman who guided LPA on tour of the facility. This is a preschool program licensed for 80 preschoolers and 24 toddlers. Facility consist of 6 classrooms. Hours of operation are Monday through Friday from 7:00am to 6:00pm.

All areas identified on the Facility Sketch were inspected. The following staff were present during this visit: Room: Butterfly classroom: 1 staff with 6 preschoolers, Bumblebee classroom: 1 staff with 5 preschoolers, Blossom classroom: 2 staff with 8 preschoolers, Duckling classroom: 1 staff with 3 toddlers, and TK classroom: 1 staff with 7 preschoolers.

Teacher/child ratios were observed to be in accordance with Title 22 regulations. The facility is within the conditions, limitations, and capacity specified on the license. Staff names were recorded. All children were observed to be always under visual supervision of a teacher.

LPA informed the Director any children enrolled in the toddler component must have written permission from the child's authorized representative.

Furniture and equipment were inspected for age appropriateness and good repair. Telephone service, heating, lighting and ventilation were evaluated. Children have their own cubbies to store their belongings.

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Raul Navarro
Tatiana Bickham
	DATE: 09/10/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/10/2026

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 NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: SHEPHERD OF THE VALLEY LUTHERAN CHURCH	FACILITY NUMBER: 197414470
	VISIT DATE: 09/10/2026

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Linens are taken home each week to be washed. Napping equipment (cots) were observed in each classroom. Per Director, the isolation area is located in the office. Age-appropriate sinks and toilets were inspected for availability and good repair in all restrooms.

LPA observed a portable sink inside of two classrooms, LPA observed the water to be too hot for the children in care. LPA informed the Director the water for the portable sinks must be changed. During the inspection the Director had the hot water disconnected for the portable sinks.

General sanitation was observed. Availability of indoor drinking water was observed in classrooms. Children bring their own water bottle. LPA observed during file review that the water was tested for lead in April 2023. The facility did not have any lead exceedances. LPA reminded the Director the facility must test their water for lead once every five years.

Disinfectants, cleaning solutions, medication and other items that are dangerous to children, were inaccessible to children. Carbon monoxide detector was observed in the classroom and is operable.

All kitchen areas/food preparation areas and food storage areas are kept clean and are free of litter, rubbish, rodents, and/or any other vermin. All storage containers for solid waste, including moveable bins have tight-fitting covers that are kept on, and in good repair. Trash cans used to discard food have tight fitting lids or solid waste bags shall be discarded immediately after each meal. LPA did not observe a thermometer in the refrigerator; LPA informed the Director to place a thermometer in the refrigerator. Food is not provided by the facility. Parents provide lunch and snacks for their child. LPA reminded the Director to ensure there is sufficient snacks available in case a child does not have one. First Aid supplies were observed. Per Director, medication is administered at the facility.

Outdoor playground equipment is in a safe condition, free of sharp, loose or pointed parts. LPA observed chipped paint on the play structure, LPA informed the Director the play structure must be painted and that they cannot have any chipped paint. All areas around or under high climbing equipment are cushioned with material that absorbs a fall. There is adequate shade in the play yard. Availability of outdoor drinking water was observed. LPA advised that no children shall be left without the supervision of a teacher at any time.

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NAME OF LICENSING PROGRAM MANAGER: Raul Navarro
NAME OF LICENSING PROGRAM ANALYST: Tatiana Bickham
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 09/10/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/10/2026

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: SHEPHERD OF THE VALLEY LUTHERAN CHURCH	FACILITY NUMBER: 197414470
	VISIT DATE: 09/10/2026

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All floors were observed to be clean and safe. All materials accessible to children were observed to be toxic-free. There are no firearms stored on the premises. There are no pools or bodies of water at the facility.

A sample of the children’s records were reviewed for Admission Agreement, LIC 700- Identification and Emergency Information, LIC 627- Consent for Medical Treatment, LIC 995A Notification of Parents’ Rights, LIC 613-Personal Rights, LIC 702-Health History, and LIC 701 Physicians Report, and Immunization Records.

Staff records were reviewed for Education, LIC-501: Personnel Record, LIC 508-Criminal Record Statement, LIC 9052- Employee Rights, LIC503- Health Screening, Proof of immunization against measles, pertussis and influenza or influenza declination, TB clearance or risk assessment, LIC 9108- Statement Acknowledging Requirement to Report Child Abuse and current Mandated Reporter Training Certificate. There is at least one person trained in CPR and Pediatric First Aid present during this inspection. During file review LPA observed a staff member and the Director to not have all of the required immunization's.

LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep as an additional resource. LPA also informed Director of the importance of checking for and removing any recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

Director was reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

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NAME OF LICENSING PROGRAM MANAGER: Raul Navarro
NAME OF LICENSING PROGRAM ANALYST: Tatiana Bickham
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 09/10/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/10/2026

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: SHEPHERD OF THE VALLEY LUTHERAN CHURCH	FACILITY NUMBER: 197414470
	VISIT DATE: 09/10/2026

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This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see PIN 22-02-CCP. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514- 0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-care-centers/. LPA observed an expired medication for one of the children, LPA informed the Director the facility must ensure all the medication is up to date.

Exit interview conducted and report was reviewed with Director. A notice of site visit was given and must remain posted for 30 days. Appeal rights were provided.

To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to [email protected]. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

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NAME OF LICENSING PROGRAM MANAGER: Raul Navarro
NAME OF LICENSING PROGRAM ANALYST: Tatiana Bickham
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 09/10/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/10/2026

LIC809 (FAS) - (06/04)

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