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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 103808749
Report Date: 03/25/2020
Date Signed: 03/26/2020 03:42:17 PM



STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710
This is an official report of an unannounced visit/investigation of a complaint received in our office on
01/23/2020 and conducted by Evaluator Juvenal Moctezuma
PUBLIC
COMPLAINT CONTROL NUMBER: 04-CC-20200123084038
FACILITY NAME:LA PETITE ACADEMYFACILITY NUMBER:
103808749
ADMINISTRATOR:CURRY, MONICAFACILITY TYPE:
830
ADDRESS:999 E. TEAGUETELEPHONE:
(559) 431-7330
CITY:FRESNOSTATE: CAZIP CODE:
93720
CAPACITY:20CENSUS: 6DATE:
03/25/2020
UNANNOUNCEDTIME BEGAN:
03:30 PM
MET WITH:Monica CurryTIME COMPLETED:
04:30 PM
ALLEGATION(S):
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1. Facility did not report child's injury to Community Care Licensing.
INVESTIGATION FINDINGS:
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On 03/25/2020, Licensing Program Analyst (LPA) Juvenal Moctezuma conducted an unannounced inspection to conclude the complaint investigation that was initiated on January 28, 2020. LPA met with Director, Monica Curry and Assistant Director, Sandra Dominguez and explained the reason of the inspection and investigation findings. A Tour of the center was conducted, and census was taken.

During the course of the investigation, LPA interviewed and obtained information from reporting party, center staff, and reviewed facility records. The investigation revealed that child #1 had an incident on 01/21/2020 which led to child #1 being taken to the doctor. Through interviews, it was confirmed that the center was aware but did not report the incident to the Fresno Regional Office as part of the reporting requirements regulation.

Based upon observations, records obtained, and information gathered through interviews, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. (Continued on attached LIC9099-C)
Substantiated
Estimated Days of Completion: 90
SUPERVISOR'S NAME: Duane MatsubaraTELEPHONE: (559) 650-7855
LICENSING EVALUATOR NAME: Juvenal MoctezumaTELEPHONE: (559) 580-0275
LICENSING EVALUATOR SIGNATURE:

DATE: 03/25/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/25/2020
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 5
Control Number 04-CC-20200123084038
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME: LA PETITE ACADEMY
FACILITY NUMBER: 103808749
VISIT DATE: 03/25/2020
NARRATIVE
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Per California Code of Regulations, Title 22, Division 12, Chapter 1, the following type B deficiency is being cited on the attached LIC 9099D.

An exit interview conducted with Monica Curry. The licensee was provided a copy of their appeal rights (LIC9058 12/15) and their signature on this form acknowledges receipt. A Notice of Site Visit Form was posted to parent's board and must remain posted for 30 days.
SUPERVISOR'S NAME: Duane MatsubaraTELEPHONE: (559) 650-7855
LICENSING EVALUATOR NAME: Juvenal MoctezumaTELEPHONE: (559) 580-0275
LICENSING EVALUATOR SIGNATURE:

DATE: 03/25/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/25/2020
LIC9099 (FAS) - (06/04)
Page: 2 of 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710
This is an official report of an unannounced visit/investigation of a complaint received in our office on
01/23/2020 and conducted by Evaluator Juvenal Moctezuma
PUBLIC
COMPLAINT CONTROL NUMBER: 04-CC-20200123084038

FACILITY NAME:LA PETITE ACADEMYFACILITY NUMBER:
103808749
ADMINISTRATOR:CURRY, MONICAFACILITY TYPE:
830
ADDRESS:999 E. TEAGUETELEPHONE:
(559) 431-7330
CITY:FRESNOSTATE: CAZIP CODE:
93720
CAPACITY:20CENSUS: 6DATE:
03/25/2020
UNANNOUNCEDTIME BEGAN:
03:30 PM
MET WITH:Monica CurryTIME COMPLETED:
04:30 PM
ALLEGATION(S):
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1. Staff did not provide adequate supervision.
INVESTIGATION FINDINGS:
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On 03/25/2020, Licensing Program Analyst (LPA) Juvenal Moctezuma conducted an unannounced inspection to conclude the complaint investigation that was initiated on January 28, 2020. LPA met with Director, Monica Curry and Assistant Director, Sandra Dominguez and explained the reason of the inspection and investigation findings. A Tour of the center was conducted, and census was taken.

During the course of the investigation, LPA interviewed and obtained information from reporting party, center staff, and reviewed facility records. Through interviews and documentation obtained, it was revealed that the center has video surveillance but can only keep footage for 7 days so video footage was not able to be viewed. Through interviews, it was also confirmed that the center was aware of Child #1's needs and services and even though the center stated they were in ratio during the time of the incident, there's no confirmation that staff did or not provide adequate supervision.

(Continued on attached LIC9099-C)
Unsubstantiated
Estimated Days of Completion: 90
SUPERVISOR'S NAME: Duane MatsubaraTELEPHONE: (559) 650-7855
LICENSING EVALUATOR NAME: Juvenal MoctezumaTELEPHONE: (559) 580-0275
LICENSING EVALUATOR SIGNATURE:

DATE: 03/25/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/25/2020
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 04-CC-20200123084038
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME: LA PETITE ACADEMY
FACILITY NUMBER: 103808749
VISIT DATE: 03/25/2020
NARRATIVE
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Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is UNSUBSTANTIATED.

Per California Code of Regulations, Title 22, Division 12, Chapter 1, no deficiency was cited.

An exit interview conducted with Director, Curry. A Notice of Site Visit Form was posted on parent's board and must remain posted for 30 days.
SUPERVISOR'S NAME: Duane MatsubaraTELEPHONE: (559) 650-7855
LICENSING EVALUATOR NAME: Juvenal MoctezumaTELEPHONE: (559) 580-0275
LICENSING EVALUATOR SIGNATURE:

DATE: 03/25/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/25/2020
LIC9099 (FAS) - (06/04)
Page: 5 of 5
Control Number 04-CC-20200123084038
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: LA PETITE ACADEMY
FACILITY NUMBER: 103808749
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/25/2020
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
04/03/2020
Section Cited
CCR
101212(d)(1)(B)
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Upon the occurrence, during the operation of the child care center of any of the events specified in (d)(1) below, a report shall be made to the Department by telephone or fax within the Department's next working day and during its normal business hours.1 (B) Any injury to any child that requires medical treatment.
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Licensee stated that she will write a plan of correction stating how this will not happen again and submit a written copy to CCL by no later than 04/03/2020.
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This requirement was not met as evidenced by the center failing to report child #1's incident to CCL that occurred on 01/21/2020. This poses a potential health and safety and/or personal rights risk to the children in care
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Duane MatsubaraTELEPHONE: (559) 650-7855
LICENSING EVALUATOR NAME: Juvenal MoctezumaTELEPHONE: (559) 580-0275
LICENSING EVALUATOR SIGNATURE:

DATE: 03/25/2020
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/25/2020
LIC9099 (FAS) - (06/04)
Page: 3 of 5