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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197419435
Report Date: 06/27/2025
Date Signed: 06/27/2025 11:46:22 AM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
This is an official report of an unannounced visit/investigation of a complaint received in our office on
04/28/2025 and conducted by Evaluator Elicia Calvillo
COMPLAINT CONTROL NUMBER: 58-CC-20250428092214
FACILITY NAME:LITTLE TREEHOUSE ACADEMYFACILITY NUMBER:
197419435
ADMINISTRATOR:ANNA SHIROKOVAFACILITY TYPE:
850
ADDRESS:18510 PLUMMER STREETTELEPHONE:
(818) 772-9320
CITY:NORTHRIDGESTATE: CAZIP CODE:
91324
CAPACITY:85CENSUS: 25DATE:
06/27/2025
UNANNOUNCEDTIME BEGAN:
08:00 AM
MET WITH:Anna Shirokova, DirectorTIME COMPLETED:
10:00 AM
ALLEGATION(S):
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Day care child sustained unexplained injuries while in care.
INVESTIGATION FINDINGS:
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On 06/27/2025 at 08:15 AM, Licensing Program Analyst (LPA) Elicia Calvillo conducted an unannounced complaint investigation on the above-mentioned allegation to deliver findings. LPA identified self and met with Masha Arzhelik, Office Assistant who guided analyst on a tour of the inside and outside of the facility. LPA observed 25 Children and 5 staff at the facility upon arrival. At 09:00 AM, Anna Shirokova, Director arrived.

Throughout the course of the investigation, LPA Calvillo obtained the LIC 9040 Child Care Facility Roster, LIC 500 Personnel Report, interviewed Director, interviewed staff, and interviewed parents.

During today’s visit, LPA addressed the allegations per Reporting Party that Day care child sustained unexplained injuries while in care.

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Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Rita Ramos
LICENSING EVALUATOR NAME: Elicia Calvillo
LICENSING EVALUATOR SIGNATURE:

DATE: 06/27/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/27/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
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Control Number 58-CC-20250428092214
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION 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: LITTLE TREEHOUSE ACADEMY
FACILITY NUMBER: 197419435
VISIT DATE: 06/27/2025
NARRATIVE
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Anna Shirokova, Director stated that the facility conducts a wellness check with each child upon arrival if there is a visible injury “ouchy” staff will have a conversation with the parents and document the conversation in Bright Wheel that parents and staff have access to view. If child has an injury “ouchy” well at the facility, the staff will attend to the child, call the parent, complete a report, and document in Bright Wheet that parents and staff have access to view.

When interviewing staff, staff did not make any disclosures regarding the allegation listed above.

When interviewing parents, parents did not make any disclosures regarding the allegation listed above.

Based on LPA’s observations, interviews which were conducted, and record review, although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegation is unsubstantiated.

The Notice of Site Visit (LIC 9213) must remain posted for 30 days during the hours of operation after each site visit by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00.

Exit interview was conducted with Anna Shirokova, Director including, but not limited to Provider Rights, Appeal Procedures and Agencies Consultative Role.

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SUPERVISORS NAME: Rita Ramos
LICENSING EVALUATOR NAME: Elicia Calvillo
LICENSING EVALUATOR SIGNATURE:

DATE: 06/27/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/27/2025
LIC9099 (FAS) - (06/04)
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