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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 195700313
Report Date: 03/06/2025
Date Signed: 03/06/2025 04:01:41 PM

Document Has Been Signed on 03/06/2025 04:01 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:MAPLE TREE MONTESSORI PRESCHOOLFACILITY NUMBER:
195700313
ADMINISTRATOR/
DIRECTOR:		SHARON COLLINSFACILITY TYPE:
860
ADDRESS:22700 SHERMAN WAYTELEPHONE:
(323) 767-4517
CITY:WEST HILLSSTATE: CAZIP CODE:
91307
CAPACITY: 104TOTAL ENROLLED CHILDREN: 104CENSUS: 0DATE:
03/06/2025
TYPE OF VISIT:PrelicensingANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:35 AM
MET WITH:Navodya Dharmasiriwardena, DirectorTIME VISIT/
INSPECTION COMPLETED:
04:16 PM
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On 03/06/2025 Licensing Program Analysts (LPA) Laticia Thompson met with Noesh Hordagoda, Applicant and Navodaya Dharmasiriwardena. The purpose of the visit was an announced pre-licensing inspection at the facility to ensure that health, safety and personal rights as required by Title 22 and Health and Safety Regulations governing California Child Care Centers will be met. There were no children present during this inspection. This is an application for a Single License with a Total capacity of 104; 24 infants ages 0-24 months, 18 Toddlers ages 18-36 months and 62 Preschoolers ages 2 years into entry of 1st grade. The child care center will operate Monday – Friday 7:00 a.m. – 6:00 p.m. LPA toured and measured the on-limits areas. The fire clearance was approved on 05/10/24. The facility has a total of 7 classrooms. Classrooms 1 and 2 will be dedicated to the Infant program, classrooms 3, 4, 5, 6 will be dedicated to the preschool. The Toddler room is located in a detached area of the facility located near the play yard areas. There are 2 additional classrooms (7 and 8) that are off limits. Preschool children will have access to 9 sinks 5 toilets and 2 Urinals. Toddlers will have access to 1 sink and 1 toilet. Infants will have access to 3 sinks. The facility is located on the Church ground of First United Methodist Church of Canoga Park.

Infant Indoor measurements are:

The Infant Indoor measurements contain a total of 732.97 which will not accommodate Applicant’s request for 24 infants. Based on today’s measurement the facility infant capacity limit is 20.

SUPERVISORS NAME: Deborah Lowe
LICENSING EVALUATOR NAME: Laticia S Thompson
LICENSING EVALUATOR SIGNATURE: DATE: 03/06/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/06/2025
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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: MAPLE TREE MONTESSORI PRESCHOOL
FACILITY NUMBER: 195700313
VISIT DATE: 03/06/2025
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Toddler Indoor measurements are:

The Toddler Indoor measurements contain a total of 535.57 which will not accommodate Applicant’s request for 18 toddlers. Based on today’s measurement the facility Toddler capacity limit is 15.

Preschool Indoor measurements are:

The Preschool Indoor measurements contain a total of 2029.70 which will not accommodate Applicant’s request for 62 Preschoolers. Based on today’s measurement the facility Preschool capacity limit is 58.

Infant Outdoor Activity measurements are:

The Infant outdoor activity space total measurements contain a total of 1,922 which will accommodate Applicant’s request for 24 infants.

Toddler Outdoor measurements are:

The Toddler outdoor activity space total measurements contain a total of 2,688 which will accommodate Applicant’s request for 18 Toddlers.

Preschool Outdoor Activity measurements are:

The Preschool outdoor activity space total measurements contain a total of 12,762.38 which will accommodate Applicant’s request for 62 Preschoolers.

The following was observed:



Parents will enter and exit through each individual classroom doors where they will sign children in and out manually on the sign in and out sheets.

The facility has filtered water dispensers in each classroom where children can fill their personal water bottles for outdoor and indoor activities. There are operable carbon monoxide detector located in every classroom. LPA observed fire extinguishers with an inspection date of 03/04/25. LPA observed First Aid Kits that were missing some required materials including a handheld digital thermometer.
SUPERVISORS NAME: Deborah Lowe
LICENSING EVALUATOR NAME: Laticia S Thompson
LICENSING EVALUATOR SIGNATURE:

DATE: 03/06/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/06/2025
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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: MAPLE TREE MONTESSORI PRESCHOOL
FACILITY NUMBER: 195700313
VISIT DATE: 03/06/2025
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Furniture and equipment were observed to be maintained in good condition free of sharp, loose or pointed parts. Tables and chairs were observed to meet the needs of the children. There are a sufficient amount of cots for napping. There are portable cubbies in all classrooms for storage of children clothing and personal belongings. Classroom 6 has central air, classrooms 1-5 and the Toddler room have individual air units for heating and cooling. The classrooms were clean in good repair. Classrooms have adequate lighting. Windows were in good repair free of chipping paint, insects and debris. LPA observed small amount of dirt along window seals. LPA observed trash cans with tight fitting lids. The facility is equipped with cell phone specifically designated for facility use. The cell phone will remain at the facility during operating hours. Disinfectants, cleaning solutions, and other items that are dangerous to children will be stored in classroom cabinets located above the sink area inaccessible to children.

All toilets, handwashing and bathing facilities are maintained in safe and sanitary operating condition. Handwashing fixtures do not deliver hot water.

The applicant shall be responsible for ensuring that children with obvious symptoms of illness are not accepted. The isolation area for Ill children will be in the office area. The isolation area shall be equipped with a cot or crib for ill children and shall be supervised by staff. The staff restroom will be designated for children who are ill.


The facility has developed and implement a written plan to record the administration of prescription and nonprescription medications, to inform the child's authorized representative daily when such medications have been given. Medication will be stored in the office in a lock box inaccessible to children. Medication that requires refrigeration will be stored in a refrigerator located in the office inaccessible to children.

The program does not provide breakfast lunch or snacks. LPA advised facility to have an emergency storage of food for children whom may require food when parents fail to provide on any particular day.
SUPERVISORS NAME: Deborah Lowe
LICENSING EVALUATOR NAME: Laticia S Thompson
LICENSING EVALUATOR SIGNATURE:

DATE: 03/06/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/06/2025
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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: MAPLE TREE MONTESSORI PRESCHOOL
FACILITY NUMBER: 195700313
VISIT DATE: 03/06/2025
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The required postings are posted in each classroom for parents and visitors to review. Facility has a disaster and mass casualty plan of action. The plan shall be in writing and shall be readily available with contingency plans for action during fires, floods and earthquakes.

The facility does not provide transportation. Firearms and other weapons shall not be allowed on or stored on the premises of a child care. The director and owner stated there aren’t any firearms or weapons on the premises. LPA advised facility representatives that smoking is prohibited on the premises of a child care center as specified in Health and Safety Code Section 1596.795(b). A baby walker shall not be allowed on the premises of a child care center in accordance with Health and Safety Code Sections 1596.846(b) and (c). Licensees shall reveal each child care center license number in all advertisements in accordance with Health and Safety Code Section 1596.861

Infants

There are 11 cribs and 3 portable changing tables located in the infant area and 2 portable changing tables in the toddler area. LPA advised director that crib mattress shall be covered with a appropriate fitted sheet. Cribs shall not limit the ability of staff to see the infant, LPA observed a changing table with a padded surface no less than one-inch thick, covered with washable vinyl or plastic, raised sides at least three inches high in good repair and safe condition. Director was reminded that while in use the changing table must be placed within arm’s reach of a sink.

Prior to the infant's first day at the center, the infant care center director or assistant director shall complete a needs and services plan for the infant. Bottles, dishes and containers of food brought by infants authorized representatives shall be labeled with infants name and current date.

The facility does not have a refrigerator for infant bottles, formula and food.
SUPERVISORS NAME: Deborah Lowe
LICENSING EVALUATOR NAME: Laticia S Thompson
LICENSING EVALUATOR SIGNATURE:

DATE: 03/06/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/06/2025
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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: MAPLE TREE MONTESSORI PRESCHOOL
FACILITY NUMBER: 195700313
VISIT DATE: 03/06/2025
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LPA reviewed and provided applicant will copies and postings of Title 22 regulations related to infant safe sleep, , Infant Care Center Sleeping Equipment, Staff Ratios, Infant Needs and Service Plans,


1596.956 Child day care centers serving infants; optional toddler program; departmental guidelines and regulations

(2) A child younger than 18 months of age shall not be moved into the toddler program. A child who is older than 18 months of age shall not be required to be in the toddler program.


(3) Parents shall give permission for the placement of their children in the toddler program.

LPA advised applicant of the following regarding the toddler Program:

101216.4(a)(1) Preschool Program with Toddler Component A child who is between 18 months and 36 months of age may participate in the toddler program with written permission from the child's authorized representative. No child in the toddler program shall be placed in the preschool program before the age of 30 months without written permission from the child's authorized representative.

Outdoor

The entire outdoor activity grounds are enclosed by a fence to protect children and to keep them in the outdoor activity area. The fence is at least four feet high. Areas around and under climbing equipment, swings, slides and other similar equipment has artificial grass and rubber turf for cushioning to prevent injury from falls. The outdoor activity space was observed and maintained in good condition. LPA observed some hazards in the outdoor activity area (see plan of corrections) There is adequate shade and benches for resting in the outdoor activity area. LPA did not observe any bodies of water. Facility representatives stated there are no bodies of water on the premises.

SUPERVISORS NAME: Deborah Lowe
LICENSING EVALUATOR NAME: Laticia S Thompson
LICENSING EVALUATOR SIGNATURE:

DATE: 03/06/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/06/2025
LIC809 (FAS) - (06/04)
Page: 5 of 8
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: MAPLE TREE MONTESSORI PRESCHOOL
FACILITY NUMBER: 195700313
VISIT DATE: 03/06/2025
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The following items were discussed:

The director was reminded that all adults 18 and over responsible for administration or direct supervision of staff, persons who provides care and supervision to children, and staff who have contact with children, 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 reviewed with facility representative the LIC 311A, Records To Be Maintained At The Facility, for child’s records, personnel records, administrative records, and documents to be posted.

To receive important licensed-related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

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).
SUPERVISORS NAME: Deborah Lowe
LICENSING EVALUATOR NAME: Laticia S Thompson
LICENSING EVALUATOR SIGNATURE:

DATE: 03/06/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/06/2025
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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: MAPLE TREE MONTESSORI PRESCHOOL
FACILITY NUMBER: 195700313
VISIT DATE: 03/06/2025
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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, available at: http://www.ada.gov/childqanda.htm

The applicant and director 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.

LPA discussed the safe sleep regulations with Director 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, licensee, or facility representative] 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.

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platforms. To receive important licensed related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

SUPERVISORS NAME: Deborah Lowe
LICENSING EVALUATOR NAME: Laticia S Thompson
LICENSING EVALUATOR SIGNATURE:

DATE: 03/06/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/06/2025
LIC809 (FAS) - (06/04)
Page: 7 of 8
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: MAPLE TREE MONTESSORI PRESCHOOL
FACILITY NUMBER: 195700313
VISIT DATE: 03/06/2025
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The following corrections are needed before a licensure will be considered.

Provide proof of first aid kit with all required material and a thermometer.
Proof of repair for air units located in room 1 and the toddler room.
Dust/clean window seal areas.
Provide proof of age-appropriateness of climbing apparatus located on the preschool outdoor activity space located next to the Toddler room.
Updated Facility Sketch including Preschoolers additional outdoor activity space.
Facility will repair wooded wall fencing, rusted play equipment protectant around trees, water spigot and metal play equipment.
Facility will purchase a variety of age-appropriate outdoor toys and equipment for infants
Facility will purchase a variety of age-appropriate washable toys and equipment for infants. Facility will ensure toys shall be auditory, visual and tactile stimulating.
Facility will purchase a refrigerator to store infant formula and food and will ensure a thermostat will be installed to regulate temperature.

Corrections are due by 03/21/2025

An exit interview was conducted with plan of corrected items discussed. LPA provided the director with appeal rights and a copy of this report. Final license determination will be made upon review by the Licensing Program Manager and corrections.
SUPERVISORS NAME: Deborah Lowe
LICENSING EVALUATOR NAME: Laticia S Thompson
LICENSING EVALUATOR SIGNATURE:

DATE: 03/06/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/06/2025
LIC809 (FAS) - (06/04)
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