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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376701365
Report Date: 08/25/2021
Date Signed: 08/25/2021 04:50:19 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME:LA PETITE ETOILE 360 PRESCHOOLFACILITY NUMBER:
376701365
ADMINISTRATOR:ALEJANDRA NORMA DIAZFACILITY TYPE:
850
ADDRESS:4555 PARK BOULEVARDTELEPHONE:
(858) 449-4891
CITY:SAN DIEGOSTATE: CAZIP CODE:
92116
CAPACITY:20CENSUS: 24DATE:
08/25/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Celine TheanoTIME COMPLETED:
04:00 PM
NARRATIVE
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On 08/25/2021 at 9:00am, Licensing Program Analysts (LPAs) Martha Malane and David Miller, conducted an unannounced Annual Inspection and met with staff member Jennifer Nelson. Owner, Celine Theano arrived at the facility at 9:30am. LPA disclosed the purpose of the inspection and toured the facility indoors and outdoors. This is a full day program which operates year around. Hours of operation are Monday – Friday 8:00am – 5:00pm. There are currently four (4) classrooms in operation.

The following ratios were observed:
  • Classrooms 1 & 2 (serves children age 2 through 5 years) seven (7) children with S4 (incomplete transcripts)
  • Classroom 5 (serves children age 2 through 5 years) six (6) children with two (2) staff members
  • There were no children present in room 3 during the inspection
  • There were 11 children with S3 (incomplete transcripts) in the outdoor activity area


There was a total of 24 children present with four (4) staff members.

Owner stated there is no swimming pool or other bodies of water on the premises and LPAs did not observe any bodies of water during today’s inspection. Stated there are no firearms or ammunition allowed or stored on the premises. Disinfectants, cleaning solutions, medication and other hazardous items are made inaccessible. No poisons were observed during the inspection.

Furniture and equipment are in good condition. Playground equipment is in safe condition at the time of this inspection. The surface of the outdoor activity space is maintained in a safe condition and is free of hazards. Toilets and handwashing facilities are in safe and sanitary operating condition. Floors in the facility are clean. Kitchen and storage areas are clean, free of litter/rubbish and free of rodents/vermin. Food is protected against contamination and any contaminated food is discarded immediately. Solid waste storage containers have tight-fitting covers and are in good repair. Drinking water is available both indoors and outdoors. The facility is free of flies, insects and rodents. Facility has one or more functioning carbon monoxide detectors that meet statutory requirements.

See LIC80C continuation...
SUPERVISOR'S NAME: Tulam VuTELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: Martha MalaneTELEPHONE: (619) 767-2231
LICENSING EVALUATOR SIGNATURE:

DATE: 08/25/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/25/2021
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 6
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME: LA PETITE ETOILE 360 PRESCHOOL
FACILITY NUMBER: 376701365
VISIT DATE: 08/25/2021
NARRATIVE
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A review of staff records on this date indicates that S3 does not have a caregiver background check associated to this facility. Upon notification from the Department, the licensee will comply and act immediately to terminate the employment of, remove from the facility or bar entry to any person it is deemed necessary while the Department considers granting or denying an exemption. Capacity and limitations as specified on the license are not being maintained as there were 24 children present and capacity for this facility is 20. At least one person trained in CPR and Pediatric First Aid is present when children are at the facility or at offsite activities. The facility does not have a center director or a fully qualified teacher. The person who signs the child in/out of the facility shall use their full legal signature and record the time of day. LPA reviewed a sample of children’s files and observed files were complete with contact information for authorized representative and or relatives or others who can assume responsibility for the child and medical assessment. LPA and owner discussed having contact information updated annually for child’s authorized representatives. LPA reviewed a sample of staff files and observed files were incomplete. Immunization records for influenza, pertussis and measles and current documentation of completed mandated reporter training were observed in staff files. Meals and snacks are brought from home.

This facility provides Incidental Medical Services (IMS). LPAs reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. Upon review, LPA observed medication for C1, C2 and C3 were not properly maintained. Licensee is aware that an IMS plan is required to be submitted to the licensing office if they provide any of these services. Information regarding Americans with Disability Act (ADA) can be obtained by contacting US Department of Justice toll free ADA Information line at (800) 514-0301(voice), (800) 514-0383 (TDD) and website link https://www.ada.gov/childqanda.htm.

See LIC809C continuation...
SUPERVISOR'S NAME: Tulam VuTELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: Martha MalaneTELEPHONE: (619) 767-2231
LICENSING EVALUATOR SIGNATURE:

DATE: 08/25/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/25/2021
LIC809 (FAS) - (06/04)
Page: 5 of 6
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME: LA PETITE ETOILE 360 PRESCHOOL
FACILITY NUMBER: 376701365
VISIT DATE: 08/25/2021
NARRATIVE
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LPA and owner discussed the Community Care Licensing website www.ccld.ca.gov which will provide access to Provider Information Notices (PINs), Quarterly Updates, COVID-19 Information and Resources, Mandated Reporter Training, California Megan’s Law (www.meganslaw.ca.gov), Lead Poisoning Facts, Forms and Regulations.

LPA discussed facility licensing fees were due by April 2, 2021. LPA provided facility PIN to make an online payment. Owner stated she will pay the fees by 9/1/2021.

Per Title 22, Division 12, Chapter 1, of the California Code of Regulations, the following deficiencies are being cited: (see next page, 809 D). Upon receipt of a Type A violation, licensee shall post and provide copies of this licensing report to parents/guardians of children in care at the facility and to parents/guardians of children newly enrolled at the facility during the next 12 months. A copy of the Fact Sheet - Child Care Parent Notification Requirements and a copy of LIC 9224 was given to licensee.

An exit interview was conducted with owner. The owner was provided a copy of their appeal rights (LIC 9058)

This report shall be made available to the public upon request. LIC 9213 Notice of Site Visit is provided and required to be posted for 30 days.
SUPERVISOR'S NAME: Tulam VuTELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: Martha MalaneTELEPHONE: (619) 767-2231
LICENSING EVALUATOR SIGNATURE:

DATE: 08/25/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/25/2021
LIC809 (FAS) - (06/04)
Page: 2 of 6
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108

FACILITY NAME: LA PETITE ETOILE 360 PRESCHOOL
FACILITY NUMBER: 376701365
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/25/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
08/25/2021
Section Cited

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101170(e)(2)Criminal Record Clearance. Prior to working or volunteering in a licensed child care facility, all individuals subject to a criminal record review shall request a transfer of a criminal record clearance from another facility... This requirement was not met as evidenced by:
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Based on records review and owner's admission owner did not ensure S3 had a criminal record clearance or exemption prior to working, residing, or volunteering in the licensed facility as required, which poses an immediate Health and Safety risk to the children in care.
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Type A
08/25/2021
Section Cited

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101161(a) Limitations on Capacity(a)A licensee shall not operate a child care center beyond the conditions and limitations specified on the license, including the capacity limitation.This requirement was not met as evidenced by:
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LPA observation and owner's admision owner did not ensure the condtions and limitations as sepcified on the license were observed as there were 24 children in attendance and the facility's capacilty is for 20 which poses an immediate Health and Safety risk to the children 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.
SUPERVISOR'S NAME: Tulam VuTELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: Martha MalaneTELEPHONE: (619) 767-2231
LICENSING EVALUATOR SIGNATURE:
DATE: 08/25/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/25/2021
LIC809 (FAS) - (06/04)
Page: 3 of 6
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108

FACILITY NAME: LA PETITE ETOILE 360 PRESCHOOL
FACILITY NUMBER: 376701365
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/25/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/01/2021
Section Cited

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101226(e)(3)(A)(B)HealthRelated Services(e)In centers where the licensee chooses to handle medications: (3)Prescription medications may be administered if all of the following conditions are met: (A)…shall be administered in accordance with the label directions…(B)…approval and instructions from the child's authorized representative for the administration of the medication to the child.(1)This documentation shall be kept in the child's record. This has not been met as evidenced by:
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Based on LPA observation and records review licensee did not ensure medication was properly handled and stored as medication for C1 was not in its original container with prescription and the medication for C3 was expired and no consent forms for C2 & C3 which poses a potential risk to the health and safety to children in care.
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Type B
09/01/2021
Section Cited

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101217(a)(11)(12)Personnel Records(a)The licensee shall ensure that personnel records are maintained. Each personnel record shall contain the following information:(11)A health screening...(12)Tuberculosis test documents... This requirement was not met as evidenced by:
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Based on records review and owner’s admission owner did not ensure S1 had a health screening or Tuberculosis test documented in their file which poses a potential risk to the health and safety to children 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.
SUPERVISOR'S NAME: Tulam VuTELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: Martha MalaneTELEPHONE: (619) 767-2231
LICENSING EVALUATOR SIGNATURE:
DATE: 08/25/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/25/2021
LIC809 (FAS) - (06/04)
Page: 4 of 6
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108

FACILITY NAME: LA PETITE ETOILE 360 PRESCHOOL
FACILITY NUMBER: 376701365
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/25/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/01/2021
Section Cited

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101216.1(b)(1)(A)Teacher Qualifications… Prior to employment, a teacher shall meet the requirements of teacher shall have completed, with passing grades, at least six postsecondary semester… (A)After employment, a teacher hired under (b) above shall complete, with passing grades, at least two units each semester or quarter until the education requirement…This requirement was not met as evidenced by:
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Based on records review and owner’s admission owner did not ensure S3 and S4 met requirements as S3 did not complete or enroll in the Child Development Course and S4 did not complete or enroll in Child Development or Curriculum courses for a qualified teacher which poses a potential risk to the health and safety of children in care.
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Type B
08/25/2021
Section Cited

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101212(b)Reporting Requirements (b)The name of the child care center director, and any fully qualified teacher… shall be reported to the Department within 10 days of a change of child care center director or designee(s). This requirement was not met as evidenced by:
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Based on owner’s admission owner did not ensure the center has a qualified director since June 7, 2021.
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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.
SUPERVISOR'S NAME: Tulam VuTELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: Martha MalaneTELEPHONE: (619) 767-2231
LICENSING EVALUATOR SIGNATURE:
DATE: 08/25/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/25/2021
LIC809 (FAS) - (06/04)
Page: 6 of 6