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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198000854
Report Date: 09/22/2022
Date Signed: 09/22/2022 12:20:41 PM


Document Has Been Signed on 09/22/2022 12:20 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 GUPTAFACILITY TYPE:
840
ADDRESS:722 SO. GRAND AVE.TELEPHONE:
(909) 860-4009
CITY:DIAMOND BARSTATE: CAZIP CODE:
91765
CAPACITY:28CENSUS: 0DATE:
09/22/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
09:20 AM
MET WITH:Kamal GuptaTIME COMPLETED:
12:25 PM
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Licensing Program Analyst (LPA) Jennifer Hua conducted an unannounced case management inspection on 9/22/2022. A COVID 19 risk assessment was conducted prior to entering the facility. LPA arrived at the facility at 9:20am and met with Director Kamal Gupta, who provided a tour of the facility. There were 0 children present during the inspection.

The purpose of today's inspection is to go over the water lead test results received on 8/28/2022. Results indicate that the faucet had action level exceedance of lead. The faucet located in the kitchen had a lead result of 11.1 ppb. LPA observed the faucet located in the kitchen has been replaced. LPA spoke with the director who stated that the faucet on the little sink in the kitchen has never been used for water consumption or food preparation source. The faucet in the big (main) kitchen sink is the only use for food preparation source. During this visit, Director provided LPA completed copy of LIC 9276, LIC 9275, the facility sketch, photo to show that faucet has been replaced, photo of the main sink in the kitchen.

Per Director, retesting has been scheduled on 10/5/2022 and 10/6/2022.

Based on LPA's observation and information received. No deficiency cited.


Exit interview conducted and report was reviewed with the Facility Representative Kamal Gupta. A notice of site visit was given and must remain posted for 30 days.
SUPERVISOR'S NAME: Ana ChicoTELEPHONE: (323) 981-3374
LICENSING EVALUATOR NAME: Jennifer HuaTELEPHONE: (323) 981-3375
LICENSING EVALUATOR SIGNATURE:
DATE: 09/22/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/22/2022
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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