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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197419435
Report Date: 04/29/2026
Date Signed: 04/29/2026 12:14:16 PM

Document Has Been Signed on 04/29/2026 12:14 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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:LITTLE TREEHOUSE ACADEMYFACILITY NUMBER:
197419435
ADMINISTRATOR/
DIRECTOR:		ANNA SHIROKOVAFACILITY TYPE:
850
ADDRESS:18510 PLUMMER STREETTELEPHONE:
(818) 772-9320
CITY:NORTHRIDGESTATE: CAZIP CODE:
91324
CAPACITY: 85TOTAL ENROLLED CHILDREN: 50CENSUS: 15DATE:
04/29/2026
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:07 AM
MET WITH:Licensee Director Anna ShirokovaTIME VISIT/
INSPECTION COMPLETED:
12:35 PM
NARRATIVE
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On 4/29/26 at 8:07 AM, Licensing Program Analyst (LPA) Jeanine Lipsey conducted an unannounced case management deficiencies visit. LPA met with, Licensee Director Anna Shirokova and announced the purpose of the visit.

At 8:07am LPA observed 15 children being supervised by 1 staff for 3 minutes on the playground. LPA observed another staff come and go in and out of the classroom during that time. LPA later found out that the staff was a student from the nearby collage and the other staff was a teacher. Based on LPA observation the children were not being actively supervised by a qualified teacher.
 
On todays visit as well as the previous visit conducted on 4/8/26, LPA observed the parents to not enter the center, they drop off in the morning, and at pick up, they stand out side until their children are brought to them. The parents do not come to office. LPA observed the notice of site on the inside of the office door without the Type A citation report dated 4/8/26. LPA advised the report plus the notice of site must be in posted in an area where the parents can view for 30 days. Staff advised LPA that the report was placed on the Brightwheel app, for which the department does not have access, and most of the parents have signed except 4-5 parents. LPA advised the Type A must be posted and the signed Acknowledgement of Receipt of Licensing Report (LIC9924) must be placed in the children's file and remain for one year. This is to include the newly enrolled children as well. Based on today's observation, today's violation will be assessed a civil penalty of $100.

During LPA's on 4/8/26, The director disclose they were away from the center for 2 months and failed to notify the department of their absence.
NAME OF LICENSING PROGRAM MANAGER: Betty Bell
NAME OF LICENSING PROGRAM ANALYST: Jeanine Lipsey
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 04/29/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/29/2026
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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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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Document Has Been Signed on 04/29/2026 12:14 PM - It Cannot Be Edited


Created By: Jeanine Lipsey On 04/29/2026 at 10:04 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

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

FACILITY NAME: LITTLE TREEHOUSE ACADEMY
FACILITY NUMBER: 197419435

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/29/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
05/06/2026
Section Cited
CCR
101216.3(a)

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(a) There shall be a ratio of one teacher visually observing and supervising no more than 12 children in attendance....
This requirement is not met by evidence by:
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The Licensee will conduct an in-service training with all staff on the importance of ensuring compliance within this section. Copies of the training along with signatures of all attendees will be submitted to CCL by the POC due date.
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Based on LPA observation a student teacher was on the playground with 15 children without a qualified teacher activley supervising the children, which poses/posed a potential health, safety or personal risk to children in care.
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Type B
04/29/2026
Section Cited
HSC1596.817(a)(2)(A)

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Site visits; posting of notices; contents; citations.
(a) When the department conducts a site visit of a licensed child day care facility, the department shall post….(A) A violation...
This requirement is not met by evidence by:
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The licensee shall immedatly post Type A citation. LPA observed the citation posted ouside for parents to view today 4/29/26.
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Based of LPA observation, The type A violation was not posted at the facility as required which poses/posed a potential health, safety or personal risk to children in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Betty Bell
NAME OF LICENSING PROGRAM MANAGER:
Jeanine Lipsey
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 04/29/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/29/2026


LIC809 (FAS) - (06/04)
Page: 3 of 5
Document Has Been Signed on 04/29/2026 12:14 PM - It Cannot Be Edited


Created By: Jeanine Lipsey On 04/29/2026 at 10:38 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

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

FACILITY NAME: LITTLE TREEHOUSE ACADEMY
FACILITY NUMBER: 197419435

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/29/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
05/06/2026
Section Cited
CCR
101212(d)(1)(c)

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101212 Reporting Requirements
Upon the occurrence...a report shall be made to the Department by telephone or fax within the Department's next working day and during its normal business hours(C) Any unusual incident.
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The licensee shall provide a LIC 624 to the department by the POC date.
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This requirement is not met by evidence by:

Based on interview conducted, the director was absent from the center for 2 months, which poses/posed a potential health, safety or personal risk to children in care.
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Type B
05/06/2026
Section Cited
HSC1596.817(a)(4)

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Site visits; posting of notices; contents; citations.
(4) A statement explaining that copies of the site visit report, including, but not limited to, violations.....
This requirement is not met by evidence by:
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The licensee shall place the signed Acknowledgement of Receipt of Licensing Report (LIC9924), in the child's file today 4/29/26. LPA observed the forms in the file.
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Based on recored review of 5 files, the licensee did not place the signed Acknowledgement of Receipt of Licensing Report (LIC9924) dated 4/8/26 in the childrens's file which poses/posed a potential health, safety or personal risk to children in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Betty Bell
NAME OF LICENSING PROGRAM MANAGER:
Jeanine Lipsey
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 04/29/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/29/2026


LIC809 (FAS) - (06/04)
Page: 4 of 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: LITTLE TREEHOUSE ACADEMY
FACILITY NUMBER: 197419435
VISIT DATE: 04/29/2026
NARRATIVE
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Based on todays observation, Type B citations will be cited.

Exit interview conducted and report was reviewed with Director/Licensee Anna Shirokova. Notice of site visit was given and must remain posted for 30 days.
NAME OF LICENSING PROGRAM MANAGER: Betty Bell
NAME OF LICENSING PROGRAM ANALYST: Jeanine Lipsey
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 04/29/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/29/2026
LIC809 (FAS) - (06/04)
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