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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197494263
Report Date: 12/03/2024
Date Signed: 12/03/2024 02:27:03 PM

Document Has Been Signed on 12/03/2024 02:27 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 RO, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:MAPLE TREE ACADEMY WLA-INFANTFACILITY NUMBER:
197494263
ADMINISTRATOR/
DIRECTOR:		BLANCA SANCHEZFACILITY TYPE:
830
ADDRESS:2920 S SEPULVEDA BLTELEPHONE:
(323) 999-6930
CITY:LOS ANGELESSTATE: CAZIP CODE:
90064
CAPACITY: 70TOTAL ENROLLED CHILDREN: 70CENSUS: 27DATE:
12/03/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:00 PM
MET WITH:Amy Mach- DirectorTIME VISIT/
INSPECTION COMPLETED:
02:40 PM
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On 12/03/2024 Licensing Program Analyst (LPA) Brittany Lovest and Judy Laureano conducted an unannounced case management inspection for the purpose of ensuring the standards are being met in accordance with California Tittle 22 Regulations and California Health and Safety Codes.

LPAs met with Director Amy Mach and toured the facility both indoors and outdoors. During today’s inspection there were 27 children, 7 staff and Director, providing care and supervision.


The purpose of the visit was to deliver amended report issued on 5/22/2024.

An exit interview was conducted with Director Amy Mach. A copy of this report was provided to the Director along with the Notice of Site Visit.
SUPERVISORS NAME: Claudia Escobedo
LICENSING EVALUATOR NAME: Brittany Lovest
LICENSING EVALUATOR SIGNATURE: DATE: 12/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/03/2024
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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