566214398-7-13-2021-17-CC-JMHL-C4VTWA-20210713150514

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 566214398
Report Date: 07/13/2021
Date Signed: 07/13/2021 03:05:19 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:	LITTLE TREE PRESCHOOL, THE		FACILITY NUMBER:	566214398
ADMINISTRATOR:	LYDIA FEDORAK		FACILITY TYPE:	850
ADDRESS:	1690 E. MAIN STREET		TELEPHONE:	(805) 652-1609
CITY:	VENTURA	STATE: CA	ZIP CODE:	93001
CAPACITY:	55	CENSUS: 35	DATE:	07/13/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	01:15 PM
MET WITH:	Colleen Soles		TIME COMPLETED:	03:15 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	On July 13, 2021, at 1:15 p.m. Licensing Program Analyst (LPA) Jill Laxo conducted an unannounced 1 Year Required. LPA discussed the reason for the inspection and toured the facility with Assistant Director Colleen Soles. The preschool program operates Monday through Friday from 7:00 a.m. until 6:00 p.m. There were 35 children supervised by 5 staff members at the time of inspection. During the inspection LPA observed 24 children resting on mats, and 11 children outside with one teacher. Bathrooms were in safe and sanitary condition and free of hazards. Classrooms were adequately equipped with age and size appropriate furniture and equipment was in good condition and the indoor space free of hazards. The center offers morning and afternoon snacks. Disinfectants and cleaning supplies were not accessible to children. Drinking water was readily available both indoors and out. Playground was enclosed with equipment in safe condition including cushioning material and was free of hazards. There were no bodies of water. Assistant director stated there are no guns nor ammunition on the premises. Personnel records were viewed and contained documents for education, AB 1207, health screening, CPR/First Aid expires 09/21/2021, and criminal background clearance. Sign in/out digital records were reviewed. Files for three enrolled children were reviewed and found complete with required licensing forms including authorized representative contact information and medical assessment. CONTINUED ON 809C.

SUPERVISOR'S NAME: Ana Tolentino	TELEPHONE: (805) 562-0347
LICENSING EVALUATOR NAME: Jill M Hazelhofer-Laxo	TELEPHONE: (805) 635-5097
LICENSING EVALUATOR SIGNATURE:	DATE: 07/13/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/13/2021

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: LITTLE TREE PRESCHOOL, THE	FACILITY NUMBER: 566214398
	VISIT DATE: 07/13/2021

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 discussed with Assistant Director PIN 20-01 Lead Testing requirements.

LPA discussed COVID 19 guidance and best practices. Assistant Director was reminded that it is their responsibility to know the regulations for the facility, which can be accessed at www.ccld.ca.gov.

In areas evaluated, no deficiencies were observed.

LPA witnessed Assistant Director post the Notice of Site visit (LIC 9213)

SUPERVISOR'S NAME: Ana Tolentino	TELEPHONE: (805) 562-0347
LICENSING EVALUATOR NAME: Jill M Hazelhofer-Laxo	TELEPHONE: (805) 635-5097
LICENSING EVALUATOR SIGNATURE:	DATE: 07/13/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/13/2021

LIC809 (FAS) - (06/04)

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