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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 566214398
Report Date: 07/01/2022
Date Signed: 07/01/2022 02:25:16 PM


Document Has Been Signed on 07/01/2022 02:25 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, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117



FACILITY NAME:LITTLE TREE PRESCHOOL, THEFACILITY NUMBER:
566214398
ADMINISTRATOR:LYDIA FEDORAKFACILITY TYPE:
850
ADDRESS:1690 E. MAIN STREETTELEPHONE:
(805) 652-1609
CITY:VENTURASTATE: CAZIP CODE:
93001
CAPACITY:55CENSUS: 29DATE:
07/01/2022
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Lydia FedorakTIME COMPLETED:
02:45 PM
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On July 1, 2022 at 1:00 PM Licensing Program Analyst (LPA) Austin Rios conducted an unannounced Case Management inspection. Prior to entering the facility, LPA conducted Covid-19 screening questions. Director provided LPA a tour of the facility inside and out. There were 29 children in care at the time of the inspection.

Facility sent in application for a Toddler Option, requesting a capacity of 6 (Ages 18-30 months) to existing preschool. Community Care Licensing (CCL) received an approved fire clearance from Ventura County Fire Department on 4/21/2022.

Facility is not increasing capacity as they are already licensed for 55 children. Facility is now being approved for 49 preschool children and 6 toddlers.

Facility Measurements:

Indoor - 20.9 ft. x 15.9 which met the requirement for 6 children

Outdoor- 84 ft. x 12 ft 7in which also met the requirement for 6 children.

LPA discussed the measurements and capacity of 6 children with the director. Director advised she understood.

As of today, July 1, 2022 the toddler option is approved for 6 children.



THE NOTICE OF SITE VISIT WAS POSTED AS REQUIRED BY H&S CODE SEC. 1596.817.
SUPERVISOR'S NAME: Ana TolentinoTELEPHONE: (805) 562-0437
LICENSING EVALUATOR NAME: Austin RiosTELEPHONE: (805) 635-4725
LICENSING EVALUATOR SIGNATURE:
DATE: 07/01/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/01/2022
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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