197409418-4-20-2023-12-CC-CHEH-CR3MPB-20230420094650

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197409418
Report Date: 04/17/2023
Date Signed: 04/20/2023 09:47:13 AM

Document Has Been Signed on 04/20/2023 09:47 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
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME:	LA PETITE ACADEMY		FACILITY NUMBER:	197409418
ADMINISTRATOR:	ASHLEY PEREZ		FACILITY TYPE:	830
ADDRESS:	28041 SECO CANYON ROAD		TELEPHONE:	(661) 297-0977
CITY:	SAUGUS	STATE: CA	ZIP CODE:	91350
CAPACITY:	16	CENSUS: 4	DATE:	04/17/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	01:03 PM
MET WITH:	Maria Goldman		TIME COMPLETED:	03:05 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 4/17/2023, Licensing Program Analyst Carol Heath met with Director Maria Goldman today for the purpose of conducting an unannounced Annual/Random inspection of the infant program. The hours of operation are 6:30 AM - 6:30 PM, Monday - Friday. The infant center consists of 1 room. LPA observed 4 infants, 1 teacher. The center also has an Preschool Program (197401087) and a School-age (197401088) Program. Incidental Medical Services (IMS) were discussed. Physical Plant Furniture and equipment were inspected for age appropriateness and good repair (highchairs and feeding tables have broad-based legs, highchair trays lock, highchairs are washable, changing table padding thickness in regulation and are within arm's length, seating table and chairs are age appropriate). There are no walkers on the premise. The bedding is changed daily (washed). The bedding is stored separately and properly inside the cubbies. Used diapers are put in a trash (diaper pail) container with a lid underneath changing table. Each child will have (already in Infant #1 room) a container labeled (photo and name) with personal items. The infant room is clean and safe. Children potty trained in a 2-year-old classroom.

SUPERVISOR'S NAME: Claretta Yates	TELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Carol Heath	TELEPHONE: (661) 202-3709
LICENSING EVALUATOR SIGNATURE:	DATE: 04/10/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/10/2023

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)

Page: 1 of 9

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: LA PETITE ACADEMY	FACILITY NUMBER: 197409418
	VISIT DATE: 04/17/2023

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
26
27
28
29
30
31
32

There are two evacuation cribs. There is a sink near the changing area for children. Sanitation solution not accessible to infants (under the sink with lock). Caregivers are reminded to wash their hands before and after each feeding and each diaper change.
Age-appropriate cribs, cots, changing tables, and feeding chairs were observed to be clean and in good repair. LPA observed sinks within arm’s reach of changing tables, soap, and paper towels available. LPA observed cubbies for each child with labeled containers for personal items. The director states they are sanitized daily (bleach & water), and linens are also washed and changed daily. They are stored separately within separate cubbies. The Center uses an electronic system to log daily infant activity. *Sign in and Out sheets were reviewed.
LPA observed 6 cribs (2 cribs are evacuation cribs). All flooring was found to be clean and safe. LPA observed staff wearing disposable booties in the infant room. The room’s disinfectants, cleaning solutions, poisons and other items that are dangerous or hazardous were inaccessible to children and stored by magnetic lock in cabinets.
The outdoor: No outdoor yard for the infant program
The parent board was reviewed and has all the required forms posted. Fire/earthquake drills current. Children are inspected for illnesses as they arrive. A review of medication policy indicated that prescription medication is administered only with the parent's written permission. The Director administers medication and documents the dosage, date, and time on a log. Medication is properly labeled and stored in its original container. There are currently no children in care with IMS needs. There is a separate area for the isolation and care of ill children in the director's office. There is a mat available for ill children.

SUPERVISOR'S NAME: Claretta Yates	TELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Carol Heath	TELEPHONE: (661) 202-3709
LICENSING EVALUATOR SIGNATURE:	DATE: 04/17/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/17/2023

LIC809 (FAS) - (06/04)

Page: 5 of 9

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: LA PETITE ACADEMY	FACILITY NUMBER: 197409418
	VISIT DATE: 04/17/2023

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
26
27
28
29
30
31
32

An isolated toilet and sink are available for ill children in the staff restroom.
The Teacher to child ratio was observed and staff names were recorded. Care and supervision were evaluated to determine if the basic needs of children are met and appropriate. LPA observed a parent board consisting of licensing-required postings. Fire/earthquake drills current.
Staff Records/ Children Records: Children's records and staff records were reviewed. Children's records and staff records were reviewed. LPA verified there is at least 1 staff person present with current CPR and First Aid Training. All staff completes the Mandated Reporter training every 2 years. All staff receives Measles, Pertussis, and Influenza vaccination. All staff has required fingerprinting associated with the facility. LPA observed 5 children's files contained all required licensing documents. Sleeping log is in the classroom binder. LPA did not observed LIC Individual Sleeping Plan (LIC9227) in children’s file
Food Service: There was 1 additional refrigerator/freezer inside of the infant classroom. LPA observed bottles labeled with the infant's names and current date.
*First Aid supplies were inventoried, and a review of medication policy, including administering, labeling, and storage.
*Telephone service, heating, lighting, and ventilation were evaluated.
*Isolation area for sick children is located in the front office.
ADMINISTRATION:
*Director is aware that the Department has full inspection authority as specified in Health and Safety Code 1596.852, 1596.853, and 1596.535.
*There were no excluded individuals present during the inspection; staff present were fingerprint cleared and associated.

SUPERVISOR'S NAME: Claretta Yates	TELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Carol Heath	TELEPHONE: (661) 202-3709
LICENSING EVALUATOR SIGNATURE:	DATE: 04/17/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/17/2023

LIC809 (FAS) - (06/04)

Page: 6 of 9

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: LA PETITE ACADEMY	FACILITY NUMBER: 197409418
	VISIT DATE: 04/17/2023

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
26
27
28
29
30
31
32

LPA observed children and contained emergency contact information. The sleeping log was reviewed. The staff did follow Safe Sleep Regulation to conduct 10-15 minute checks.
The following general information was discussed during this inspection:
The incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. 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)/ (800) 514-0383 (TTY) and link to the publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm. The Center does not provide IMS at this time.
Mandated Reporter Training Requirements: §1596.8662 - As of January 1, 2018, childcare providers, administrators, or employees who work in a licensed facility shall complete the mandated reporter training provided according to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training. Staff was informed that they need to take mandated reporter training.
Immunization Requirements: §1596.7995 (a)(1) Commencing September 1, 2016, a person shall not be employed or volunteer at a daycare center if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year.

SUPERVISOR'S NAME: Claretta Yates	TELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Carol Heath	TELEPHONE: (661) 202-3709
LICENSING EVALUATOR SIGNATURE:	DATE: 04/17/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/17/2023

LIC809 (FAS) - (06/04)

Page: 7 of 9

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: LA PETITE ACADEMY	FACILITY NUMBER: 197409418
	VISIT DATE: 04/17/2023

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
26
27
28
29
30
31
32

*All Licensing reports are available for review online and are considered public information. Summary: Assembly Bill 2621 added Section 1596.819 to the Health and Safety Code, to require the Department to post certain licensing information for CCCs and FCCHs on its public internet website.
Fingerprint clearances and transfers: Before working or volunteering in a licensed childcare facility, all individuals subject to a criminal record review shall obtain a clearance or criminal record exemption. If a fingerprint clearance has been obtained through the Department, Licensee may request a transfer of a criminal record clearance from one state-licensed facility to another using form LIC 9184
Safe Sleep in Child Care: Resources can be found on our website at http://www.cdss.ga.gov/inforesources/Child-Care-Licensing/Public-Information-and-Resources/Safe-Sleep
Per the Health & Safety Code §1596.846 (b) and (c); states that a baby walker shall not be kept or used on the premises of a child day care facility. The California Code of Regulations, Title 22, Division 12, Chapter 3, Section 102417 (g)(10), under Operation of Family Child Care Home; states that a baby walker shall not be allowed on the premises of a family child care home. Legislature declared that a baby walker or item of similar nature are considered an immediate risk to the child's safety as they are inherently unsafe and not capable of design changes that would or prevent accidents

SUPERVISOR'S NAME: Claretta Yates	TELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Carol Heath	TELEPHONE: (661) 202-3709
LICENSING EVALUATOR SIGNATURE:	DATE: 04/17/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/17/2023

LIC809 (FAS) - (06/04)

Page: 8 of 9

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: LA PETITE ACADEMY	FACILITY NUMBER: 197409418
	VISIT DATE: 04/17/2023

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
26
27
28
29
30
31
32

**Senate Bill AB 633 - Child Care Facilities: Parent Notification Requirements
Summary: This bill amends Health and Safety Code (HSC) sections 1596.859, 1596.8595, 1596.8895, and 1597.05 to improve the transparency of licensing records and to ensure that parents/guardians using a licensed childcare facility are aware of situations that present the greatest danger to children.

No deficiencies are being cited at this time, the facility complies with Title 22

Exit interview conducted with Director. A copy of this report is discussed and left with the director, Maria Goldman.

SUPERVISOR'S NAME: Claretta Yates	TELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Carol Heath	TELEPHONE: (661) 202-3709
LICENSING EVALUATOR SIGNATURE:	DATE: 04/17/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/17/2023

LIC809 (FAS) - (06/04)

Page: 9 of 9