406215890-11-26-2019-17-CC-MKST-BJAUSQ-20191126145045

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 406215890
Report Date: 11/26/2019
Date Signed: 11/26/2019 02:50:52 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME:	LEARNING TREE, THE		FACILITY NUMBER:	406215890
ADMINISTRATOR:	KELSEY SULLIVAN		FACILITY TYPE:	850
ADDRESS:	2607 TRAFFIC WAY		TELEPHONE:	(805) 466-1133
CITY:	ATASCADERO	STATE: CA	ZIP CODE:	93422
CAPACITY:	40	CENSUS: 0	DATE:	11/26/2019
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	08:50 AM
MET WITH:	Kelsey Sullivan		TIME COMPLETED:	11:50 AM

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) Melissa Stewart conducted an announced Pre-Licensing inspection and met with owner/director, Kelsey Sullivan. This is a location change inspection for the combination preschool and school age center. Previous school age facility number 406213639. The school age indoor and outdoor activity areas were toured and measured. LPA observed cubbies for children's belongings in the entry hall way which separates the preschool from the school age activity areas. The restrooms at the end of the hallway will be used by both the school age children and the preschool children depending on the time of day. Director stated that no co-mingling of age groups will occur. LPA observed sign and out and parent notice board, tables and chairs, carpeted reading area with couches, age appropriate toys, games, activity areas and learning materials. LPA observed that cleaning supplies are stored in a locked closet in the restroom. Director reported that there is a fully equipped kitchen located off the indoor activity area which will not be used at this time and will be kept locked while children are present. This facility has a functioning carbon monoxide detector. Drinking water is available both indoors and outdoors. Director reported that there are no guns or ammunition in the center. The school age outdoor activity area is located on the opposite side of the preschool outdoor activity area. The activity area is completely fenced and there are no bodies of water. LPA observed a storage shed, play house, climbing structure located on wood chips to absorb a fall, tetherball, basketball hoop and tables in a shaded area. Continued on 809-C

SUPERVISOR'S NAME: Maria Mueller	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Melissa K Stewart	TELEPHONE: (805) 689-6267
LICENSING EVALUATOR SIGNATURE:	DATE: 11/26/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/26/2019

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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME: LEARNING TREE, THE	FACILITY NUMBER: 406215890
	VISIT DATE: 11/26/2019

NARRATIVE

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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

LPA reviewed and provided Director with a copy of “Safe to Sleep" brochure. LPA provided the “Effects of Lead Exposure” brochure to be distributed to all families. Director was advised to review Quarterly Updates and Provider Information Notices (PINs) which can be accessed on-line at www.ccld.ca.gov.

The facility was inspected by Atascadero City Fire Department and fire clearance was granted on 11/19/19. Based on indoor and outdoor space, toilets and sinks, this facility meets Title 22, Division 12 requirements for a school age center with a capacity of 36 children.

License effective today, 11/26/19.

LPA observed Director post the Notice of Site visit.

Due to computer malfunction, LPA left facility at 11:20pm, re-wrote report and returned to the facility at 1:15pm

SUPERVISOR'S NAME: Maria Mueller	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Melissa K Stewart	TELEPHONE: (805) 689-6267
LICENSING EVALUATOR SIGNATURE:	DATE: 11/26/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/26/2019

LIC809 (FAS) - (06/04)

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