197419435-8-13-2025-58-CC-ECAO-DKHQ7F-20250813115505

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197419435
Report Date: 08/13/2025
Date Signed: 08/13/2025 11:55:20 AM

Document Has Been Signed on 08/13/2025 11:55 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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME:	LITTLE TREEHOUSE ACADEMY		FACILITY NUMBER:	197419435
ADMINISTRATOR/ DIRECTOR:	ANNA SHIROKOVA		FACILITY TYPE:	850
ADDRESS:	18510 PLUMMER STREET		TELEPHONE:	(818) 772-9320
CITY:	NORTHRIDGE	STATE: CA	ZIP CODE:	91324
CAPACITY: 85	TOTAL ENROLLED CHILDREN: 85	CENSUS: 22	DATE:	08/13/2025
TYPE OF VISIT:	Annual/Required	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	08:22 AM
MET WITH:	Anna Shirokova, Director		TIME VISIT/ INSPECTION COMPLETED:	12:30 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	On 08/13/2025 at 08:22 AM, Licensing Program Analyst (LPA) Elicia Calvillo conducted an unannounced Annual Required Inspection Visit. The facility is located at 18510 Plummer Street, Northridge, CA. 91324. LPA identified self and met with Anna Shirokova, Director, LPA identified reason for visit and provided Entrance Checklist -Child Care Centers (LIC 125) to help facilitate the inspection. Facility Representative (FR) Anna Shirokova, Director allowed entry to the facility and provided LPA with a guided tour of inside and outside of the facility. The facility is currently licensed for a capacity of 85, per FR they currently have 50 enrolled. The facility hours of operation are currently Monday through Friday from 08:00 AM to 05:00 PM. Required postings were observed posted in Main Office. The facility is made up of 4 Preschool classrooms and 1 Infant classroom. The facility will increase to 5 classrooms as enrollment increases, there is a large room that is divided into classroom areas that allows the facility to decrease or increase the number of classrooms. Classroom #1 is used for Infants; Classroom #2 ages 2-year-old to 2.5-year-olds, with 2 staff; Classroom #3 ages 2.5-year-old to 3-year-olds with 2 staff; Classroom #4 ages 3-year-old to 4-year-olds, and Classroom #5 are ages 4-year-old to 5-year-olds with 1 staff. Beginning at 08:45 AM, LPA observed the following in Classroom #2, Classroom #3, Classroom #4, and Classroom #5. The furniture, toys, and equipment were inspected for age appropriateness and were in good PAGE 1 OF 4

NAME OF LICENSING PROGRAM MANAGER: Rita Ramos
NAME OF LICENSING PROGRAM ANALYST: Elicia Calvillo
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 08/13/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/13/2025

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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California Health & Human Services Agency

California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:

Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.

Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)

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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: LITTLE TREEHOUSE ACADEMY	FACILITY NUMBER: 197419435
	VISIT DATE: 08/13/2025

NARRATIVE

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good repair. There are cubbies used for each child to store their personal belongings. There is drinking water readily available with individual sippy cups and each classroom has pitchers of water available to refill the individual sippy cups. The restroom(s) were inspected for safety and sanitation. There were age-appropriate sinks and toilets located in Classroom #2, Classroom #3, and Classroom #4 and there was available water, water temperature was appropriate, toilet paper was provided. The facility has a telephone service and there the heating, lighting and ventilation were evaluated for safety and comfort.

LPA observed first aid kits in each classroom and conducted an inventory for necessary supplies. LPA observed a device on the classroom ceilings; per FR it is a combination fire / carbon monoxide detector. LPA observed smoke detectors via a fire alarm. The Disaster Drill log was available, and the last disaster drill was conducted on 07/01/2025. Per FR, an isolation area for sick children, is in the main office. Hazardous items including poisonous cleaning compounds were stored inaccessible to children and LPA observed cleaning solutions stored in a high cabinet in the restrooms.

LPA did observe the kitchen area/ food preparation area, per FR snacks and meals are provided by the facility. Snack and meal menus are posted in each classroom. LPA did not observe any open containers in the refrigerator. Food preparation was inspected for safety and sanitation, hazardous items including poisonous cleaning compounds were stored inaccessible to children with the use of door lock to the kitchen.

LPA observed that the play ground has been redesigned for safety to include more activities, new equipment, and new ground coverings. LPA toured the outdoor play area and observed playground equipment in safe condition, free of sharp, loose, or pointed parts, in good repair and age appropriate for the children in care. The surface of the outdoor activity space is maintained in a safe condition and is free of hazards. Children have access to a climbing structure located in the play area and surrounding and underneath the structure is rubber material to absorb falls. There is adequate shade provided by canopies and trees in the play yard. During outdoor play, children have access to their individual sippy cups, pitchers of water for refills, and a water fountain for drinking water while in the play yard. LPA advised that no children should be left without supervision at any time. There are no swimming pool or other bodies of water on the premises.

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NAME OF LICENSING PROGRAM MANAGER: Rita Ramos
NAME OF LICENSING PROGRAM ANALYST: Elicia Calvillo
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 08/13/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/13/2025

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: LITTLE TREEHOUSE ACADEMY	FACILITY NUMBER: 197419435
	VISIT DATE: 08/13/2025

NARRATIVE

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Beginning at 10:00 AM, an inspection of the required forms was made and documented on the LIC857 Children’s Record Review and the LIC859 Review of Staff/Volunteer Records. The record review of the children’s and staff records found the files were complete.

LPA observed that teacher-child ratios were maintained, and staff names were recorded. Care and supervision were evaluated to determine if the basic needs of children are met and appropriate. LPA observed the Personal Rights of children were provided. LPA observed the Sign-in and out sheets and reviewed the procedures. At the time of arrival for the inspection, LPA observed 22 of 22 children signed in.

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 are available at: https://www.ada.gov/resources/child-care-centers/.

For IMS information see PIN 22-02-CCP. 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 are available at: https://www.ada.gov/resources/child-care centers/.

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).

LPA verified that the lead testing was completed in accordance with the Written Directives outlined in PIN 21-21.1-CCP.

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NAME OF LICENSING PROGRAM MANAGER: Rita Ramos
NAME OF LICENSING PROGRAM ANALYST: Elicia Calvillo
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 08/13/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/13/2025

LIC809 (FAS) - (06/04)

Page: 4 of 5

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: LITTLE TREEHOUSE ACADEMY	FACILITY NUMBER: 197419435
	VISIT DATE: 08/13/2025

NARRATIVE

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Facility Representative 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.

To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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/inspection-process.

Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, no deficiencies were observed during the inspection..

A Notice of Site Visit was given and must remain posted for 30 days during the hours of operation after each site visit by a licensing representative. Failure to comply with posting requirement will result in an immediate 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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NAME OF LICENSING PROGRAM MANAGER: Rita Ramos
NAME OF LICENSING PROGRAM ANALYST: Elicia Calvillo
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 08/13/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/13/2025

LIC809 (FAS) - (06/04)

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