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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 070215161
Report Date: 08/12/2019
Date Signed: 08/12/2019 10:46:23 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME:LA PETITE ACADEMY, INC.FACILITY NUMBER:
070215161
ADMINISTRATOR:TANYA BEASLEYFACILITY TYPE:
840
ADDRESS:3891 LAKESIDE DRIVETELEPHONE:
(510) 222-3070
CITY:RICHMONDSTATE: CAZIP CODE:
94806
CAPACITY:46CENSUS: 3DATE:
08/12/2019
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
08:00 AM
MET WITH:Greta DavisTIME COMPLETED:
11:15 AM
NARRATIVE
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An unannounced Case Management Site Inspection visit was conducted by LPA Susan Neeson. Met with Greta Davis, Director. The visit started at 8:00 AM.

There are 3 school age children present and one staff person.

The purpose of the visit is to deliver typed copies of reports from 8/8/19. The reports were not able to be given at that time due to equipment malfunction.

No deficiecies were observed.

An exit interview was given.
SUPERVISOR'S NAME: Antranette RobinsonTELEPHONE: (510) 622-2591
LICENSING EVALUATOR NAME: Susan NeesonTELEPHONE: (510)622-2630
LICENSING EVALUATOR SIGNATURE:

DATE: 08/12/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/12/2019
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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