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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 313608509
Report Date: 03/16/2023
Date Signed: 03/16/2023 01:17:49 PM


Document Has Been Signed on 03/16/2023 01:17 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, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833



FACILITY NAME:LA PETITE ACADEMYFACILITY NUMBER:
313608509
ADMINISTRATOR:MEGAN ORTOLIVOFACILITY TYPE:
830
ADDRESS:5820 STANFORD RANCH ROADTELEPHONE:
(916) 624-4816
CITY:ROCKLINSTATE: CAZIP CODE:
95765
CAPACITY:24CENSUS: 12DATE:
03/16/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:45 AM
MET WITH:Megan OrtolivoTIME COMPLETED:
01:15 PM
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On March 16th, 2023, Licensing Program Analyst (LPA) Jeremey McClain met with Licensing Representative Megan Ortolivo for an unannounced required annual random inspection. LPA observed care and supervision of 10 napping infants in one classroom by two staff, and two infants supervised by one staff in another classroom. All individuals subject to criminal record review have obtained clearance.
Licensing Representative, Megan Ortolivo, was reminded that all adults 18 and working in the facility, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Child Care Center. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.
LPA inspected all activity and classroom spaces, restrooms, food service, and outdoor play areas. Hazardous items are inaccessible to children. Furniture and equipment are in operable and safe condition. Playground equipment and surfaces are free of loose or sharp parts, and adequate cushioning was observed in areas underneath climbing equipment. Toileting facilities are in safe, sanitary, and operating condition. The floors appeared clean throughout the facility. The food preparation space is free of litter and all food was protected against contamination. Storage containers with solid waste have tight-fitting covers in each classroom. No children in care require medications. LPA observed a functional carbon monoxide detector.
Infant changing tables have a padded surface that is washable and at least one-inch-thick, and the changing tables have raised sides that are at least three inches high. The floors appeared clean throughout the facility. LPA observed appropriate napping equipment for each infant in care. Cribs were equipped with appropriate fitting mattresses, tight fitting covers, and were free of loose articles and objects, including blankets and pillows.
LPA observed documented 15-minute sleep checks. Infant bottles were labeled with the date and child’s name. LPA reminded director that Infant sleep plans (LIC 9227) for infants up to 12 months old are required. LPA reminded director that Infant needs and services plan should be updated quarterly. (1/2)
SUPERVISOR'S NAME: Keven PetersTELEPHONE: (916) 263-5728
LICENSING EVALUATOR NAME: Jeremey McClainTELEPHONE: (916) 216-7801
LICENSING EVALUATOR SIGNATURE:
DATE: 03/16/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/16/2023
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 2


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833
FACILITY NAME: LA PETITE ACADEMY
FACILITY NUMBER: 313608509
VISIT DATE: 03/16/2023
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Noncontaminated Drinking water is readily available to children both indoors and outdoors. Facility has had their water sources tested for lead and were found to be at an acceptable level.
The facility currently utilizes and electronic sign in and out sheet.
LPA reviewed records for all present staff. At least one staff member present today has current Pediatric CPR and First Aid certification which expires (11/2023). All staff currently employed with the facility have: a criminal record clearance, a health screening report, immunization records, current AB1207 Mandated Reporter Training, and documentation of their educational background, training, and/or experience.

Three children records were reviewed. Each child's file contained a completed emergency contact form, immunization records, signed personal rights form, and a completed medical assessment.

Incidental Medical Services (IMS) policy was discussed. The facility is not currently providing IMS. 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 publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm.

LPA encouraged the Director was encouraged to the visit the Department's website at WWW.CDSS.CA.GOV for information regarding childcare updates, forms, regulations and legislation pertaining childcare centers. LPA also encouraged the Director to sign up for the Child Care Advocates quarterly newsletter.

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/process.

No deficiencies were observed during today’s inspection.

SUPERVISOR'S NAME: Keven PetersTELEPHONE: (916) 263-5728
LICENSING EVALUATOR NAME: Jeremey McClainTELEPHONE: (916) 216-7801
LICENSING EVALUATOR SIGNATURE:

DATE: 03/16/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/16/2023
LIC809 (FAS) - (06/04)
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