197495060-9-20-2022-30-CC-JCHR-CJFNY8-20220920105219

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197495060
Report Date: 09/19/2022
Date Signed: 09/20/2022 10:52:55 AM

Document Has Been Signed on 09/20/2022 10:52 AM - 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 VENICE		FACILITY NUMBER:	197495060
ADMINISTRATOR:	ISABEL GALINDO		FACILITY TYPE:	850
ADDRESS:	11827 VENICE BLVD		TELEPHONE:	(310) 314-1111
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90066
CAPACITY: 80	TOTAL ENROLLED CHILDREN: 80	CENSUS: 0	DATE:	09/19/2022
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	02:06 PM
MET WITH:	Amir Caspian-Owner		TIME COMPLETED:	04:30 PM

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On 9/19/2022 at 9:44 A.M. Licensing Program Analyst (LPA) Jillinda Chandler made an announced visit to Maple Tree Academy Venice for the purpose of conducting a pre-licensing inspection. The applicant is requesting an Preschool component with a capacity of 80 children, ages 3 until entry into first grade The applicant also has a pending application for a pre-school license (197495059). The two programs will be located in the same building, the building is a two story building. Two room on the lower level will be and four rooms upstairs will be dedicated to pre-school activity. The center's clearance allows for children 21/2 and older to have class on the upper level. There is an approved fire clearance conducted by Inspector Sivaborvorn of the L.A Fire Department Bureau of Fire Prevention. LPA met with Amir Caspian and a tour of the facility was conducted.
The following was observed of the:
INDOOR ACTIVITY SPACE

Fire extinguishers were 2AB10C or larger.

The school has an fully integrated fire alarm system with smoke and carbon detection

Claudia Escobedo
Jillinda Chandler
	DATE: 09/19/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/19/2022

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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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 VENICE	FACILITY NUMBER: 197495060
	VISIT DATE: 09/19/2022

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First aid kits were available with the required essentials: scissors, bandages, tweezers, and thermometer

Age appropriate equipment was observed in good repair

Drinking water will be provided through filtered water dispensers

The facility has central heating and cooling.

Windows were in good repair free of chipping paint, dirt, insects or debris

Adequate lighting was observed

The classrooms were clean in good repair

Trash cans used for solid waste were observed with tight fitting lids

No Fireplaces or open face heaters were observed

Disinfectants and cleaning solution and other toxins or poisons were made inaccessible to children, placed in locked cabinet or storage room

The office and the staff restroom will be used for isolation of ill children

The facility was equipped with a working telephone

SUPERVISOR'S NAME: Claudia Escobedo
LICENSING EVALUATOR NAME: Jillinda Chandler
LICENSING EVALUATOR SIGNATURE:	DATE: 09/19/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/19/2022

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 VENICE	FACILITY NUMBER: 197495060
	VISIT DATE: 09/19/2022

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Parents and authorized adults will sign in and out children using an electronic devise. Licensee was advised that signatures shall be readily available for printing and review upon request.

The required postings were also posted in a common area for parents and visitors review

Measurements for the indoor activity space was 1956.05 divided by 35 SQ. FT. per child = 55 preschool children

FOOD SERVICE:

Meals will be provided by parents or an option outside vendor and snacks will be provided by the school. sample menus were posted for review. Children will eat in their classrooms.

LPA observed a full kitchen that was inaccessible to children in care, the kitchen was clean refrigeration and storage for foods were observed.

Center has devised an Incidental Medical Service plan and provide to parents of children with allergies (epi-pen), asthmatic (inhalers), and children needing G-tube feeding

SUPERVISOR'S NAME: Claudia Escobedo
LICENSING EVALUATOR NAME: Jillinda Chandler
LICENSING EVALUATOR SIGNATURE:	DATE: 09/19/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/19/2022

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 VENICE	FACILITY NUMBER: 197495060
	VISIT DATE: 09/19/2022

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RESTROOMS

THERE WERE:

9 toilets = 1 toilet per 15 children for a total of 135 children

9 sinks = 1 sink per 15 children for a total of 135 children

Toilets and sinks were age appropriate

The restrooms were clean and sanitized with the necessary toiletries, sinks and toilets were operable and in good repair. Faucets delivered cold water.

OUTDOOR ACTIVITY SPACE

Age appropriate toys and equipment were observed in good condition.

The play yard gated with a 4 inch or higher gate.

No hazardous conditions or equipment was observed during today’s visit.

Sand was observed for cushioning under the climbing apparatus, and artificial grass in other areas of the outdoor activity area.

SUPERVISOR'S NAME: Claudia Escobedo
LICENSING EVALUATOR NAME: Jillinda Chandler
LICENSING EVALUATOR SIGNATURE:	DATE: 09/19/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/19/2022

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 VENICE	FACILITY NUMBER: 197495060
	VISIT DATE: 09/19/2022

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LPA observed trees and umbrella for shade and benches for resting.

Measurements for the outdoor activity area were 226.37 divided by 75 sq. ft. per child for capacity total 30 preschool children.

Based on today’s inspection the facility shall be recommended for a capacity of 55 determined by the indoor measurements and an approval of the outdoor activity space and the following correction.

A gate at bottom of the staircase
Latch on the side gate by the infant
Leveling of the pavement by the maple tree

Closing Script

To improve the quality and value of the new inspection process, a survey will 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 tools, please send them by email 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/process.

SUPERVISOR'S NAME: Claudia Escobedo
LICENSING EVALUATOR NAME: Jillinda Chandler
LICENSING EVALUATOR SIGNATURE:	DATE: 09/19/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/19/2022

LIC809 (FAS) - (06/04)

Page: 2 of 6

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 VENICE	FACILITY NUMBER: 197495060
	VISIT DATE: 09/19/2022

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applicant was reminded that all adults 18 and over, including employees and volunteers, 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 up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

LPA discussed the safe sleep regulations with applicant and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed applicant of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

Exit interview conducted and report was reviewed with the applicant Amir Caspian

SUPERVISOR'S NAME: Claudia Escobedo
LICENSING EVALUATOR NAME: Jillinda Chandler
LICENSING EVALUATOR SIGNATURE:	DATE: 09/19/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/19/2022

LIC809 (FAS) - (06/04)

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