<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 566200350
Report Date: 02/06/2024
Date Signed: 02/07/2024 01:20:20 PM

Document Has Been Signed on 02/07/2024 01:20 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, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME:LA PETITE ACADEMYFACILITY NUMBER:
566200350
ADMINISTRATOR:SHANNON SUTTONFACILITY TYPE:
850
ADDRESS:85 E. BONITA DR.TELEPHONE:
(805) 526-7846
CITY:SIMI VALLEYSTATE: CAZIP CODE:
93065
CAPACITY: 141TOTAL ENROLLED CHILDREN: 141CENSUS: 50DATE:
02/06/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:Shannon SuttonTIME COMPLETED:
02:00 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
On February 7, 2024 at 12:00 PM, Licensing Program Analyst (LPA) Laura Villanueva conducted a Case Management-Incident inspection to follow up on a self reported incident. LPA met with Director, Shannon Sutton. LPA and Director toured the facility inside and outside. There were 50 children present with 9 staff.

On January 24/2024, C1 was left unattended outside in the 2 year old playground. The teacher in charge,S1 left the playground to go to lunch at 11:36 AM, based on the sign in sheet. The center uses a tracking system of face to name report in transitions to account for children present. S1 failed to complete the face to name report before leaving the group for S3. S3 came to the playground to cover for S1. S2 took 6 children to change diapers in the 2 year old class.C2 failed to complete the face to name report prior to bringing children in the classroom. S3 brought 11 children inside and left C1 outside. S3 failed to complete dace to name report prior to bring children in classroom, S4 came back from lunch and heard crying. S4 found the C1 unattended in the 2 year old playground, crying (time unknown). At 11:50 AM C1 was brought to the Director by S4. There were 18 children at the playground when they first went outside. The class was under the supervision of S1 and S2 when they first went to the playground.

When staff are hired, they train on all the center's policies and procedures before entering a classroom. S2 and S3 were terminated from employment at the center. Center followed appropriate protocols for the incident. A type A citation for absence of supervision is being cited with a civil penalty of $500.00

A copy of this report must be provided to the authorized representatives of all currently enrolled children and must also be provided to newly enrolled children for the next 12 months. The report shall be provided no later than the next business day or the next day the child is in care.

CONTINUED ON LIC809C
George Mingle
Laura Villanueva
DATE: 02/06/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/06/2024
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 3
Document Has Been Signed on 02/07/2024 01:20 PM - It Cannot Be Edited


Created By: Laura Villanueva On 02/07/2024 at 09:06 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME: LA PETITE ACADEMY
FACILITY NUMBER: 566200350

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/06/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
02/07/2024
Section Cited

1
2
3
4
5
6
7
101229 Responsibility for Providing Care and Supervision-(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, except as specified in Sections 101216.2(e)(1) and 101230(c)(1).
8
9
10
11
12
13
14
 Supervision shall include visual observation. This requirement was not met as evidenced by: Based on LPAs observation, staff statements, record review, the licensee did not comply with the section cited above staff did not provide visual observation at all times which posed an immediate risk to the health, safety or personal rights risk to children in care.
8
9
10
11
12
13
14

1
2
3
4
5
6
7

1
2
3
4
5
6
7
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:George Mingle
LICENSING EVALUATOR NAME:Laura Villanueva
LICENSING EVALUATOR SIGNATURE:
DATE: 02/07/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/07/2024


LIC809 (FAS) - (06/04)
Page: 2 of 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME: LA PETITE ACADEMY
FACILITY NUMBER: 566200350
VISIT DATE: 02/06/2024
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
The ACKNOWLEDGEMENT OF RECEIPT OF LICENSING REPORTS (LIC 9224) shall be signed and kept in each of the children’s records. Web site address to obtain forms, review quarterly updates, review Title 22 & Health & Safety Codes is: https://www.cdss.ca.gov/inforesources/child-care-licensing

Copies of this report must be posted for 30 days in a visible location for the authorized representatives of children. Notice of Site Visit has been posted (LIC9213). The notice shall be posted for 30 consecutive days. Failure to maintain posting as required will result in a $100.00 civil penalty. Appeal right given LIC9058.

Exit interview conducted with Director, Shannon Sutton and a copy of this report was given.
SUPERVISOR'S NAME: George Mingle
LICENSING EVALUATOR NAME: Laura Villanueva
LICENSING EVALUATOR SIGNATURE:

DATE: 02/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/07/2024
LIC809 (FAS) - (06/04)
Page: 3 of 3