198000854-4-25-2022-33-CC-JHUA-CDTSCP-20220425134553

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198000854
Report Date: 04/25/2022
Date Signed: 04/25/2022 01:45:59 PM

Document Has Been Signed on 04/25/2022 01:45 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
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME:	LA PETITE ACADEMY INC.-GRAND AVE.		FACILITY NUMBER:	198000854
ADMINISTRATOR:	KAMAL GUPTA		FACILITY TYPE:	840
ADDRESS:	722 SO. GRAND AVE.		TELEPHONE:	(909) 860-4009
CITY:	DIAMOND BAR	STATE: CA	ZIP CODE:	91765
CAPACITY:	28	CENSUS: 0	DATE:	04/25/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	01:11 PM
MET WITH:	Kamal Gupta		TIME COMPLETED:	02:00 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	Licensing Program Analyst (LPA) Jennifer Hua conducted an unannounced Required - 1 year inspection. Upon arrival, LPA met with director, Kamal Gupta. A COVID-19 risk assessment was conducted prior to entry to the facility. LPA provided Director with a copy of the LIC 125 Entrance Checklist to facilitate the inspection. This is a School-Age program. Business hours are from Monday-Friday, 6:30 AM to 6:30 PM. LPA was guided to a facility tour by Director. All areas identified on the Facility Sketch were inspected. There are of total of 1 classroom. LPA observed the following: No children present during walk through. Per director, children arrive around 3pm. The facility was observed to be within the license capacity and limitations. Facility roster was reviewed. Sign-In and Sign-Out sheets were reviewed. Rooms identified on facility sketch were inspected Furniture and equipment were inspected for age appropriateness and good repair. Telephone service, heating, lighting and ventilation were evaluated. Napping equipment and bedding were inspected. Storage for children's belongings. Age appropriate sinks and toilets were inspected for availability and good repair. General sanitation was observed. Availability of indoor drinking water was observed. A first aid kit is kept in each classroom. Carbon monoxide detectors and smoke detectors are present in the facility. Fire extinguishers are serviced annually. Storage cabinet in classrooms was locked and hazardous items including cleaning compounds were stored inaccessible to children. Report continues to next page

SUPERVISOR'S NAME: Ana Chico	TELEPHONE: (323) 981-3374
LICENSING EVALUATOR NAME: Jennifer Hua	TELEPHONE: (323) 981-3375
LICENSING EVALUATOR SIGNATURE:	DATE: 04/25/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/25/2022

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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: LA PETITE ACADEMY INC.-GRAND AVE.	FACILITY NUMBER: 198000854
	VISIT DATE: 04/25/2022

NARRATIVE

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Facility provide lunch. Morning and afternoon Snacks are offered, Indoor/outdoor drinking water available for children.

Outdoor equipment was inspected for safety, cushioning material, good repair and appropriateness. Required shade, drinking water and fencing were inspected. The children have access to drinking water during outside play was observed on site. Play area was inspected for hazards and inaccessibility to bodies of water. There is no bodies of water on site. Director and staff are current in Pediatric CPR and First Aid are on file & Director. Certificate are issued EMSA approved.

Teacher child ratios were observed, and staff names recorded. Care and supervision were evaluated to determine if the basic needs of children are met and appropriate.

Staff and Children’s Records were reviewed. Criminal Record Clearances were reviewed for adults for required transfers and associations. Fingerprint clearance on file. staff files reviewed have met the Immunization requirements.

The facility provides Incidental Medical Services - IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children's, personnel, and administrative records. For IMS information see Evaluator Manual - Regulation and Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. 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 publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm Per director, no children require IMS at this time.

SUPERVISOR'S NAME: Ana Chico	TELEPHONE: (323) 981-3374
LICENSING EVALUATOR NAME: Jennifer Hua	TELEPHONE: (323) 981-3375
LICENSING EVALUATOR SIGNATURE:	DATE: 04/25/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/25/2022

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
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: LA PETITE ACADEMY INC.-GRAND AVE.	FACILITY NUMBER: 198000854
	VISIT DATE: 04/25/2022

NARRATIVE

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Mandatory Forms for the children’s files and staff files reviewed, requirements for fire drills, earthquake drills and documentation were discussed and observed. Role and responsibilities of being a Mandated Reporter were reviewed. The Director was advised how to access forms and Regulations online at www.ccld.ca.gov. Director was made aware that it is his/her responsibility to know the regulations as well as anyone who assists in providing care. The Director was advised that inaccessibility of hazards must be constantly reassessed depending on the children in care.

LPA advised that all staff 18 years of age and older providing Care & Supervision and/or have continuous presence in the facility shall adhere to a criminal background clearance with the Department of Justice, FBI and Child Abuse Index Check.

Per Director, isolation area in the director's office.

To improve the quality and value of the new inspection process, a survey will 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 tools, please send them by email 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/tion-process.

No deficiencies cited.

An exit interview conducted with Director, Appeals Rights provided. Notice of Site Visit shall be posted for 30 days accessible for review.

SUPERVISOR'S NAME: Ana Chico	TELEPHONE: (323) 981-3374
LICENSING EVALUATOR NAME: Jennifer Hua	TELEPHONE: (323) 981-3375
LICENSING EVALUATOR SIGNATURE:	DATE: 04/25/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/25/2022

LIC809 (FAS) - (06/04)

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