197494264-1-31-2024-30-CC-JLAO-D223D9-20240131170909

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197494264
Report Date: 01/31/2024
Date Signed: 01/31/2024 05:09:20 PM

Document Has Been Signed on 01/31/2024 05:09 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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME:	MAPLE TREE ACADEMY WLA PRESCHOOL		FACILITY NUMBER:	197494264
ADMINISTRATOR:	AMY SICILIANO		FACILITY TYPE:	850
ADDRESS:	2920 S SEPULVEDA BLVD		TELEPHONE:	(310) 314-1111
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90064
CAPACITY: 80	TOTAL ENROLLED CHILDREN: 80	CENSUS: 37	DATE:	01/31/2024
TYPE OF VISIT:	Required - 3 Year	UNANNOUNCED	TIME BEGAN:	12:01 PM
MET WITH:	Amy Siciliano Preschool Director		TIME COMPLETED:	03:20 PM

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On 1/31/2024 Licensing Program Analyst (LPA) Judy Laureano conducted an unannounced Annual Required Inspection at the above mentioned facility. LPA met with Amy Siciliano, Preschool Director.

Facility operates Monday through Friday from 7:30 a.m. to 5:30 p.m. Facility is licensed for 80 children ages 2 to entry to first grade. Facility is a combo program with an infant program onsite; facility number: 197494263. Outdoor waiver is on file. No more than 66 children to use the outdoor space at any given time.

LPA observed the following:
Big Leaf Maples 2- 8 children and 1 staff in the playground
Field Maples 2- 12 children and 1 staff member in the kitchen area eating lunch
Field Maples 1- 9 children and 1 staff member
Big Leaf Maples 1- 8 children and 1 staff member

Classrooms were observed and inspected. Classrooms were observed with age-appropriate materials and a variety of manipulatives. Classrooms were observed to have fine and gross motor activities centers. Each classroom was observed to have children’s cubbies where children’s store their personal belongings and areas to store their bedding and napping cots. Furniture and equipment are in good condition, free of sharp, loose or pointed parts. LPA observed First Aid kits in the classrooms and facility emergency kit outside the infant classroom.

Facility is open to enroll children that might need medication administered. Medication, if needed, is stored in the child’s perspective classroom. LPA reminded facility to ensure that all medication is stored with all necessary LIC forms. All prescription and non prescription medication shall be centrally stored in accordance with the following requirements: medication shall be kept in a safe place inaccessible to the children in care, each container shall have an unaltered label. LPA observed where medication is stored with all appropriate LIC forms and observed an allergy list posted.

Facility has a designated custodial staff that clean and disinfects the classrooms. Teachers are responsible for the day-to-day cleaning. Disinfectants and cleaning solutions are stored in the laundry room- content inaccessible to the children in care.

SUPERVISORS NAME: Claudia Escobedo
LICENSING EVALUATOR NAME: Judy Laureano
LICENSING EVALUATOR SIGNATURE:	DATE: 01/31/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/31/2024

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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: MAPLE TREE ACADEMY WLA PRESCHOOL	FACILITY NUMBER: 197494264
	VISIT DATE: 01/31/2024

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Facility provides AM/PM snacks and menus are posted. LPA advised, copies of the menus as served shall be dated and kept on file for at least 30 days. Menus shall be made available for review by the child's authorized representative and the Department upon request.

Families are responsible for providing daily meals in appropriate containers, eg lunch boxes with icepacks and/or thermos. Water is readily available to children via water dispenser. Children bring their own refillable water bottles and teacher ensure they are filled as needed.

Playground equipment is in safe condition, free of sharp, loose or pointed parts. The surface of the outdoor activity space is maintained in a safe condition and is free of hazards. Areas around high climbing equipment have cushioning material to absorb falls. Teachers ensure playground and outdoor equipment is safe and free of hazard before children use the area. Facility utilizes an indoor activity space with a retractable roof. Indoor activity space was inspected. LPA observed age appropriate outdoor equipment in both areas. LPA requested director removed a children’s bike that is missing a pedal. Director confirmed that bike will be made inaccessible to children until it is repaired and/or replaced.

LPA observed all toilets and hand washing facilities. LPA observed toilets and sinks to accommodate the facility’s capacity. Toilets flush properly, toilets and sinks are reachable by the children in care. Water temperature, toilet paper, paper towels were inspected. Floors in the facility are clean and safe. Solid waste storage containers have tight-fitting covers and are in good repair.

Parent board was observed with all necessary posting in the front lobby. Fire drills and/earthquake drill log was reviewed. Teachers received training on different ways to prepare their class for an emergency, transitions songs, games and practicing walking with a walking rope.

The facility is free of flies, insects and rodents. Facility contracts with a Pest control vendor to ensure that facility stays pest free.

SUPERVISORS NAME: Claudia Escobedo
LICENSING EVALUATOR NAME: Judy Laureano
LICENSING EVALUATOR SIGNATURE:	DATE: 01/31/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/31/2024

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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: MAPLE TREE ACADEMY WLA PRESCHOOL	FACILITY NUMBER: 197494264
	VISIT DATE: 01/31/2024

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There is no swimming pool or other bodies of water on the premises. There are no firearms or ammunition allowed or stored on the premises. LPA observed working fire extinguisher and centralize smoke detectors and fire alarm with carbon monoxide detector throughout the classrooms. All electrical outlets were observed to be covered. LPA observed a centralized sprinkler system throughout the facility.

Prior to working or volunteering in a licensed childcare facility, all individuals subject to a criminal record review have received a criminal record clearance or exemption. Upon notification from the Department, the licensee will comply and act immediately to terminate the employment of, remove from the facility or bar from entering the facility for any person it is deemed necessary while the Department considers granting or denying an exemption.

Capacity and limitations as specified on the license are being maintained during today’s inspections.

At least one person trained in CPR and Pediatric First Aid is present when children are at the facility or at offsite activities. LPA reviewed 5 staff files and observed all files with current CPR and Pediatric First Aid. LPA discussed the importance of making sure all Pediatric CPR and Pediatric First Aid training is EMSA approved. Mandated Reporter training was observed to be current for all staff. LPA reviewed a sample of children’s files and observed 6 files complete. LPA Laureano emailed facility director the updated LIC 311A and LIC 125 to use as a reference when auditing files.

The name of the child care center director or fully-qualified teacher(s) designated to act in the director’s absence has been reported to the Department. The person who signs the child in/out of the facility shall use their full legal signature and record the time of day. Sign in/out is completed electronically via Procare and hard copy is available for LPA’s review.

All children are under supervision, including visual supervision, of a teacher at all times. Facility maintains a ratio of one teacher supervising no more than 12 children in care.

To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

SUPERVISORS NAME: Claudia Escobedo
LICENSING EVALUATOR NAME: Judy Laureano
LICENSING EVALUATOR SIGNATURE:	DATE: 01/31/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/31/2024

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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: MAPLE TREE ACADEMY WLA PRESCHOOL	FACILITY NUMBER: 197494264
	VISIT DATE: 01/31/2024

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Facility representative was reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test. For child care center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1-CCP). LPA verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. 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) or (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-care-centers/.

Facility representative, Amy Siciliano was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with Amy Siciliano.

SUPERVISORS NAME: Claudia Escobedo
LICENSING EVALUATOR NAME: Judy Laureano
LICENSING EVALUATOR SIGNATURE:	DATE: 01/31/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/31/2024

LIC809 (FAS) - (06/04)

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