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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197416834
Report Date: 09/20/2022
Date Signed: 09/20/2022 06:07:04 PM


Document Has Been Signed on 09/20/2022 06:07 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
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245



FACILITY NAME:TREE HOUSE SCHOOL, THEFACILITY NUMBER:
197416834
ADMINISTRATOR:JULIANNE ABEYTAFACILITY TYPE:
850
ADDRESS:3735 MOTOR AVENUETELEPHONE:
(310) 202-8733
CITY:LOS ANGELESSTATE: CAZIP CODE:
90034
CAPACITY:60CENSUS: 29DATE:
09/20/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:37 AM
MET WITH:Julianne Abeyta- DirectorTIME COMPLETED:
06:20 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
Licensing Program Analyst (LPA), Keyona Scott, conducted an unannounced annual required inspection at the child care center on 09/20/2022. LPA met with Director, Julianne Abeyta at 11:55 AM. LPA was guided on a tour inside and outside of the Center. Children were at the end of lunch schedule and preparing for nap time upon LPA's arrival. LPA observed proper teacher to children ratios. All adults, working or volunteering at facility did not have a criminal record clearance or exemption. LPA observed Teacher 1 (T1) with the two year old classroom (Inchworms). LPA was unable to verify T1 associated on the facility roster. LPA contacted El Segundo Regional Child Care Office and spoke with LPA on duty. On duty LPA verified that T1 was not associated to facility and did not have a criminal record clearance or exemption on file with the Department. LPA advised Director and T1 that T1 would have to leave the facility and obtain a livescan and cannot return until T1 has obtained a criminal record clearance or exemption and is associated to the facility.

This is a preschool program that consists of three classrooms: Two (2) Year Old, known as the Inchworms, Three (3) Year Old (Ladybugs) and Pre-K (Butterflies). LPA observed kitchen play sets, cubbies, books, tables and chairs sets, arts and crafts materials in each classroom. Facility operation hours are Monday through Friday, 7:30 AM to 5:00 PM.

Physical Plant
LPA observed all areas identified on the facility sketch. The facility was kept clean, neat and orderly. There are four properly working toilets and five sinks in the preschool bathroom that are safe and sanitary. All poisons and hazardous items are stored in the kitchen and inaccessible to children in care. All floors are clean and safe.
The kitchen is inaccessible to children in care by safety gate at kitchen entranceway. Kitchen was kept clean and free of litter, rubbish and rodents and/or any other vermin. Trash cans used to discard food have tight fitting lids. Drinking water is readily available both indoors and outdoors. Facility was observed to be free of flies, gnats and other insects and rodents. PAGE 1
SUPERVISOR'S NAME: Claudia EscobedoTELEPHONE: (424) 301-3044
LICENSING EVALUATOR NAME: Keyona ScottTELEPHONE: (424) 301-3091
LICENSING EVALUATOR SIGNATURE:
DATE: 09/20/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/20/2022
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 6


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: TREE HOUSE SCHOOL, THE
FACILITY NUMBER: 197416834
VISIT DATE: 09/20/2022
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
26
27
28
29
30
31
32
Outdoor playground equipment is in safe condition and is free of sharp, loose or pointed parts. The surface of the outdoor activity space is maintained in a safe condition and is free of hazards. LPA observed slides, swings and similar equipment that was safe and cushioned with material around and under all areas to absorb a fall. There is adequate shade in the play yard.

FACILITY RECORDS
There is at least one person present at facility that is trained in Pediatric CPR and First Aid. The name of the child care center director or fully qualified teacher(s) designated to act in the director's absence is on file.

LPA reviewed seven staff files of the following personnel records during today's inspection: Staff Qualifications; Proof of immunization of measles (MMR), pertussis (Tdap) and influenza; Current Pediatric CPR and First Aid Certification; TB clearance or risk assessment; LIC 503 (Health Screening Report); LIC 508 (Criminal Record Statement); LIC 9108 (Statement Acknowledging Requirement to Report Child Abuse); Mandated Reporter Training Certificate; LIC 9052 (Employee Rights)

LPA reviewed ten children's files of the following children's records: LIC 613A (Personal Rights); Admission Agreement; LIC 700 (Identification and Emergency Information); LIC 701 (Physician's Report); LIC 995 (Notification of Parents' Rights); LIC 627 (Consent for Emergency Medical Treatment); Immunization Record

LPA observed the following during today's inspection:

· Facility License

Per Director, is in process of updating parent board. LPA provided Director with the following required postings to place on the parent board:

· PUB 393- Notification of Parents' Rights
· LIC 610- Emergency Disaster Plan (Director completed during inspection and provided LPA with a copy to place in file at the El Segundo Regional Child Care Office)
· LIC 613A- Personal Rights
PAGE 2
SUPERVISOR'S NAME: Claudia EscobedoTELEPHONE: (424) 301-3044
LICENSING EVALUATOR NAME: Keyona ScottTELEPHONE: (424) 301-3091
LICENSING EVALUATOR SIGNATURE:

DATE: 09/20/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/20/2022
LIC809 (FAS) - (06/04)
Page: 3 of 6
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: TREE HOUSE SCHOOL, THE
FACILITY NUMBER: 197416834
VISIT DATE: 09/20/2022
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
26
27
28
29
30
31
32
During today's inspection, Director printed to following required posting to place on parent board:

· PUB 269- Child Passenger Restraint System Poster

Per Director, there is no menu available for review due to parents provide child(ren)'s daily meals and snacks; however, there is food available at the Center in case meal and/or snack is not provided by parent.

LPA reviewed the following documents during today's inspection:

· Verification of Disaster Fire Drills: Per review, last fire and earthquake drill was conducted on 08/24/2022.
· Daily Activity Schedule
· Sign In/Out Sheets

LPA provided Director with the following form for review and completion:

· LIC 9148 Earthquake Preparedness Checklist

The following was thoroughly discussed:
Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, an updated Plan of Operation that includes IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice
(USDOJ) toll-free ADA Information Line at (800) 514-0301
(voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

Director was reminded that all adults 18 and over, including employees and volunteers, 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 up to $500.00 maximum per day/per person will be assessed if this regulation is violated. PAGE 3
SUPERVISOR'S NAME: Claudia EscobedoTELEPHONE: (424) 301-3044
LICENSING EVALUATOR NAME: Keyona ScottTELEPHONE: (424) 301-3091
LICENSING EVALUATOR SIGNATURE:

DATE: 09/20/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/20/2022
LIC809 (FAS) - (06/04)
Page: 4 of 6
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: TREE HOUSE SCHOOL, THE
FACILITY NUMBER: 197416834
VISIT DATE: 09/20/2022
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
26
27
28
29
30
31
32
Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

The facility was not operating in substantial compliance during today’s inspection on 09/20/2022. Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, deficiency cited.

LPA Keyona Scott informed Director, Julianne Abeyta, that this report dated 0920/2022 documents one (1)Type A citation which shall be posted for 30 consecutive days as there is immediate risk to the health, safety, or personal rights of children in care.
Also, LPA Keyona Scott informed the Director, Julianne Abeyta to provide a copy of this licensing report dated 09/20/2022 that documents any Type A citation to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

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

Exit interview conducted and report was reviewed with Director, Julianne Abeyta.

To improve the quality and value of the new inspection process, a survey will 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 tools, please send them by email to inspectionprocess@dss.ca.gov. 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/process.


PAGE 4
SUPERVISOR'S NAME: Claudia EscobedoTELEPHONE: (424) 301-3044
LICENSING EVALUATOR NAME: Keyona ScottTELEPHONE: (424) 301-3091
LICENSING EVALUATOR SIGNATURE:

DATE: 09/20/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/20/2022
LIC809 (FAS) - (06/04)
Page: 5 of 6
Document Has Been Signed on 09/20/2022 06:07 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245


FACILITY NAME: TREE HOUSE SCHOOL, THE
FACILITY NUMBER: 197416834

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/20/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
101170(a)

(a) The Department shall conduct a criminal record review of all persons specified in Health and Safety Code Section 1596.871(b). The Department has the authority to approve or deny a facility license, or employment, residence or presence in the facility, based on the results of this review.
This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on observation, interview and record review, the licensee did not comply with the section cited above in one (1) out of six (6) persons which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 09/21/2022
Plan of Correction
1
2
3
4
Director will provide a declaration to the Department verifying is aware that all persons working or volunteering at the Center must have a criminal record clearance or exemption before presence at the facility. Director will also verify ALL persons associated to facility with the staff and/or volunteers present at the facility on a yearly basis on LIS 555 (Notice of Facility Roster) and return to El Segundo Child Care Regional Office. Director will email declaration to LPA by 09/21/2022.
Section Cited
Deficient Practice Statement
1
2
3
4
POC Due Date:
Plan of Correction
1
2
3
4

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Claudia EscobedoTELEPHONE: (424) 301-3044
LICENSING EVALUATOR NAME: Keyona ScottTELEPHONE: (424) 301-3091
LICENSING EVALUATOR SIGNATURE:
DATE: 09/20/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/20/2022
LIC809 (FAS) - (06/04)
Page: 6 of 6