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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013421347
Report Date: 12/05/2024
Date Signed: 12/05/2024 11:57:58 AM

Document Has Been Signed on 12/05/2024 11:57 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
OAKLAND CC RO, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME:PEAR TREE PRESCHOOL, THEFACILITY NUMBER:
013421347
ADMINISTRATOR/
DIRECTOR:		FATIMA IBRAHIMFACILITY TYPE:
850
ADDRESS:8100 WINTHROPE STTELEPHONE:
(510) 636-1810
CITY:OAKLANDSTATE: CAZIP CODE:
94605
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 11DATE:
12/05/2024
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:38 AM
MET WITH:Araceli De AndaTIME VISIT/
INSPECTION COMPLETED:
12:05 PM
NARRATIVE
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LPA D. Campos conducted a case management inspection as a result of a complaint investigation at The Pear Tree School. The facility did not report a recent change in administration when their Director resigned on 7/31/2024. Reporting requirements were discussed with licensee Michele Hamilton and acting Director Araceli De Anda today.

See LIC809D for Type B deficiency cited today.
SUPERVISORS NAME: Sherelle Johnson
LICENSING EVALUATOR NAME: Diana Campos
LICENSING EVALUATOR SIGNATURE: DATE: 12/05/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/05/2024
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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Document Has Been Signed on 12/05/2024 11:57 AM - It Cannot Be Edited


Created By: Diana Campos On 12/05/2024 at 11:15 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
, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: PEAR TREE PRESCHOOL, THE
FACILITY NUMBER: 013421347

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/05/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
12/19/2024
Section Cited
CCR
101212(a)(b)

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Reporting Requirements
(a)Each licensee or applicant shall furnish to the Department reports as required by the Department including, but not limited to, the following: (b)The name of the child care center director, and any fully qualified teacher(s) designated to act in the child care center director's absence, shall be reported to the Department within 10 days of a change of child care center director or designee(s)..
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Facility shall submit by the POC date a written summary of understanding of the Reporting requirement regulation along with an official notice of the administration change that occurred on 7/31/2024.
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This requirement not met as evidenced by: Facility did not notify licensing change in administration within 10 days of Director's last day at school which poses a potential risk to the health and safety of persons 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.
SUPERVISOR'S NAME:Sherelle Johnson
LICENSING EVALUATOR NAME:Diana Campos
LICENSING EVALUATOR SIGNATURE:
DATE: 12/05/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/05/2024


LIC809 (FAS) - (06/04)
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