Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197419073
Report Date: 03/16/2016
Date Signed 03/16/2016 01:57:36 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 6167 BRISTOL PARKWAY #400
CULVER CITY, CA 90230
FACILITY NAME:RAINBOW CHILDREN'S ACADEMY, CORP.FACILITY NUMBER:
197419073
ADMINISTRATOR:KELLY COLEMANFACILITY TYPE:
850
ADDRESS:1213 CENTINELA AVENUETELEPHONE:
(310) 672-2400
CITY:INGLEWOODSTATE: CAZIP CODE:
90302
CAPACITY:168CENSUS: 42DATE:
03/16/2016
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
09:55 AM
MET WITH:Ekateria Brando, Owner, Kelly Coleman, (has designation of responsibility form) and Clara Harper, Teacher and Alma, Receptionist TIME COMPLETED:
01:15 PM
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
The Licensing Program Analyst (LPA) A. Tang met with Kelly Coleman and Teacher Ms. Harper regarding an incident that occurred on January 13, 2016 on the play yard. The injury reportedly occurred after 5 pm. Interviews of relevant parties were conducted today. There will be follow-up to this visit concerning this incident.

A copy of this report was given to Owner Ekaterina Brando.
SUPERVISOR'S NAME: Mary RuizTELEPHONE: (310) 337-4826
LICENSING EVALUATOR NAME: Angela TangTELEPHONE: (310) 337-4379
LICENSING EVALUATOR SIGNATURE:

DATE: 03/16/2016
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/16/2016
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