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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384002282
Report Date: 01/09/2023
Date Signed: 01/09/2023 03:52:24 PM

Document Has Been Signed on 01/09/2023 03:52 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, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME:LITTLE TREE PRESCHOOLFACILITY NUMBER:
384002282
ADMINISTRATOR:COCHRUM, GIGIFACILITY TYPE:
850
ADDRESS:3161 MISSION STREETTELEPHONE:
(415) 647-7524
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94110
CAPACITY: 22TOTAL ENROLLED CHILDREN: 17CENSUS: 16DATE:
01/09/2023
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
03:00 PM
MET WITH:Carolina FerrucciTIME COMPLETED:
04:00 PM
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On 1/9/2022 at 3:00PM., Licensing Program Analyst (LPA) Luis J. Gomez met with Lead Teacher, Carolina Ferrucci. Purpose of the inspection was explained and was for an unannounced; Plan of Correction inspection. Present were three staff caring for 16 children. All children are preschool age. LPA inspected facility indoor and outdoor for health and safety hazards.

During today’s inspection, LPA performed record review and interviews.

At 3:30PM., LPA observed staff member present has renewed their required cardiopulmonary resuscitation (CPR) / first aid certification, expiring 10/2024. Proof completed training has been stored in the staff file.

Deficiency issued on 9/29/2022, has been cleared and ‘Cleared Plan of Correction Letter’ was provided.

Based on today's inspection, no deficiencies were observed in the areas evaluated according the Title 22 Division 12 Ca. Code of Regulations. Exit interview was discussed with Lead Teacher, Carolina Ferrucci and signature of this form acknowledges receipt of these documents.

This report must be available in the facility for public review. Notice was provided and must remain posted for 30 days. Licensee was advised for additional questions to call CCL Office, M-F, 8am-5pm, 650-266-8800 or 1-844-538-8766. Website: www.ccld.ca.gov
SUPERVISORS NAME: Cindy Interiano
LICENSING EVALUATOR NAME: Luis Gomez
LICENSING EVALUATOR SIGNATURE: DATE: 01/09/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/09/2023
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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