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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197492821
Report Date: 10/12/2020
Date Signed: 11/25/2020 09:06:04 AM

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:MAPLE TREEFACILITY NUMBER:
197492821
ADMINISTRATOR:CASPIAN, STEPHANIEFACILITY TYPE:
830
ADDRESS:1814 14TH STREETTELEPHONE:
(310) 473-8733
CITY:SANTA MONICASTATE: CAZIP CODE:
90404
CAPACITY:32CENSUS: 0DATE:
10/12/2020
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
01:16 PM
MET WITH:Amir CaspianTIME COMPLETED:
01:47 PM
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On 10/12/2020 at 11:25 A.M. Licensing Program Analyst (LPA) Chandler made an announced visit to Maple Tree Preschool for the purpose of conducting a licensee initiated case management inspection to increase the facility capacity from a current capacity of 32 to a capacity of 40. LPA met with Amir Caspian (Administrator) who provided a tour of the facility.

Licensee plans to accomplish the request by adding one additional classroom and an outdoor waiver. A granted fire clearance is on file for a capacity of 40, the fire clearance was conducted by Daniel Galvan of the Santa Monica Fire Prevention Division on 2/28/2020.

The facility's current capacity was granted based on outdoor activity space. The facility uses a modified indoor space for outdoor activities, and was granted a capacity of less than the requested capacity due to the limited outdoor space.

The facility was granted an outdoor activity space waiver at the time of licensing allowing the outdoor activity space to be used on a staggered play schedule.

There are no additional areas being added to the current infant program, the licensee is requesting a new waiver to add an additional play schedule to accommodate the requested capacity increase based on the original granted capacity.

Lpa inspected the facility for health and safety compliance, no deficiencies or hazardous conditions were observed. Based on todays inspection the facility will be recommended for an increased capacity.

SUPERVISOR'S NAME: Peter FloresTELEPHONE: (424) 301-3077
LICENSING EVALUATOR NAME: Jillinda ChandlerTELEPHONE: (424) 301-3068
LICENSING EVALUATOR SIGNATURE:

DATE: 11/06/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/06/2020
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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