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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 313623849
Report Date: 03/24/2022
Date Signed: 03/24/2022 12:06:40 PM


Document Has Been Signed on 03/24/2022 12:06 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 ACADEMY - EUREKAFACILITY NUMBER:
313623849
ADMINISTRATOR:COURTNEY WILLIAMSFACILITY TYPE:
840
ADDRESS:1800 EUREKA RDTELEPHONE:
(916) 783-7700
CITY:ROSEVILLESTATE: CAZIP CODE:
95661
CAPACITY:14CENSUS: 0DATE:
03/24/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Courtney WilliamsTIME COMPLETED:
12:00 PM
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On March 24, 2022, Licensing Program Analyst (LPA) Jeremey McClain met with Director Courtney Williams for an unannounced required annual random inspection. No children were present during the inspection.

The facility operates Monday through Friday from 7 am to 6 pm.

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. Medications are appropriately stored and inaccessible to children. LPA observed a functional carbon monoxide detector.

The facility prepares breakfast, lunch, and snack. Menus were posted showing planned meals at least a week in advance sess. The facility currently utilizes an electronic sign in and sign out system.

LPA reviewed records for all present staff. At least one staff member present today has current Pediatric CPR and First Aid certification which expires:03/2024 . 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.

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.

REPORT CONTINUED ON THE FOLLOWING PAGE.

SUPERVISOR'S NAME: Keven PetersTELEPHONE: (916) 263-5728
LICENSING EVALUATOR NAME: Jeremey McClainTELEPHONE: (916) 216-7801
LICENSING EVALUATOR SIGNATURE:
DATE: 03/24/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/24/2022
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, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833
FACILITY NAME: LA PETITE ACADEMY - EUREKA
FACILITY NUMBER: 313623849
VISIT DATE: 03/24/2022
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Drinking water is available to children indoors and outdoors through water fountains and a pitcher. LPA informed the Director about Assembly Bill 2370, which will require certain licensed Child Care Facilities to test their water for excessive amounts of lead. Testing will be required beginning January 1, 2020.

Incidental Medical Services (IMS) policy was discussed. The facility is currently providing IMS and has a plan of operation in place. 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.

This report was reviewed with the director and an exit interview was conducted.



No deficiencies were observed during today’s inspection.

A Notice of Site Visit was provided and should remain posted for 30 days.
SUPERVISOR'S NAME: Keven PetersTELEPHONE: (916) 263-5728
LICENSING EVALUATOR NAME: Jeremey McClainTELEPHONE: (916) 216-7801
LICENSING EVALUATOR SIGNATURE:

DATE: 03/24/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/24/2022
LIC809 (FAS) - (06/04)
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