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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 364801080
Report Date: 06/23/2025
Date Signed: 06/23/2025 11:31:19 AM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE CC RO, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
This is an official report of an unannounced visit/investigation of a complaint received in our office on
05/28/2025 and conducted by Evaluator Laura Mejorado
PUBLIC
COMPLAINT CONTROL NUMBER: 09-CC-20250528151422
FACILITY NAME:LA PETITE ACADEMYFACILITY NUMBER:
364801080
ADMINISTRATOR:DEBRA RIVASFACILITY TYPE:
850
ADDRESS:620 BASELINETELEPHONE:
(909) 874-5113
CITY:RIALTOSTATE: CAZIP CODE:
92376
CAPACITY:68CENSUS: 23DATE:
06/23/2025
UNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Debra Rivas, DirectorTIME COMPLETED:
11:00 AM
ALLEGATION(S):
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Lack of Supervision - Day care child sustained injury due to staff neglect
INVESTIGATION FINDINGS:
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On this date and time, Licensing Program Analyst (LPA) Laura Mejorado arrived at the facility to conclude a complaint investigation which was initiated on 6/4/25. LPA met with Director Debra Rivas, toured the facility, took census, and discussed the following.

During the investigation, LPA made observations, reviewed pertinent documentation, and conducted interviews with pertinent parties. It was alleged, a day care child sustained an injury due to staff neglect. LPA investigated the allegation and gathered the following information:

Please see LIC9099C
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Ana Noble
LICENSING EVALUATOR NAME: Laura Mejorado
LICENSING EVALUATOR SIGNATURE:

DATE: 06/23/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/23/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 5
Control Number 09-CC-20250528151422
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE CC RO, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME: LA PETITE ACADEMY
FACILITY NUMBER: 364801080
VISIT DATE: 06/23/2025
NARRATIVE
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It was reported, on 5/22/25 a child sustained an injury due to staff neglect. While conducting interviews it was disclosed a child threw an object across the classroom which hit another child on the side of their face. Interviews stated initially staff did not know what had been thrown or what the child had been hit with. For this reason, when the incident report was written it stated an “object” had been thrown which hit the child in the face. Later in the day it was disclosed the “object” that had been thrown was a child’s sized chair. Although staff was present during the incident, staff did not observe the incident occurred and did not know what the child had been hit with on the side of their face.

Based on LPA observations, interviews, and record review, the preponderance of evidence standard has been met, therefore the above allegation(s) is found to be SUBSTANTIATED. California Code of Regulations, (Title 22, Division 12 & Chapter 1), are being cited on the attached LIC9099D.

LPA Mejorado informed Director Debra Rivas that this report dated 6/23/25 document(s) one Type A citation(s) which shall be posted for 30 consecutive days as there is/are immediate risk(s) to the health, safety, or personal rights of children in care.

A notice of site visit was given and must remain posted for 30 days.

Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Also, LPA Mejorado informed Director Debra Rivas to provide a copy of this licensing report dated 6/23/25 that documents any Type A citation(s) to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

Exit interview conducted and report was reviewed with Director Debra Rivas.
SUPERVISORS NAME: Ana Noble
LICENSING EVALUATOR NAME: Laura Mejorado
LICENSING EVALUATOR SIGNATURE:

DATE: 06/23/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/23/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 5
Control Number 09-CC-20250528151422
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE CC RO, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: LA PETITE ACADEMY
FACILITY NUMBER: 364801080
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/23/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
06/24/2025
Section Cited
CCR
101229(a)(1)
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(a) The licensee shall provide care and supervision as necessary to meet the children's needs. (1) No child(ren) shall be left without the supervision of a teacher at any time… Supervision shall include visual observation.
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Facility agrees to conduct an in-service training regarding supervision and submit the agenda along with the participation list to CCL by 6/24/25.
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Based on observations and interviews, a day care child sustained an injury due to staff neglect, which poses a potential/immediate health, safety or personal rights risk to persons in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Ana Noble
LICENSING EVALUATOR NAME: Laura Mejorado
LICENSING EVALUATOR SIGNATURE:

DATE: 06/23/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/23/2025
LIC9099 (FAS) - (06/04)
Page: 5 of 5