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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 153801105
Report Date: 09/17/2021
Date Signed: 09/17/2021 02:00:21 PM

Document Has Been Signed on 09/17/2021 02:00 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, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME:LA PETITE ACADEMY, INC.FACILITY NUMBER:
153801105
ADMINISTRATOR:MORENO, MARY ANNFACILITY TYPE:
850
ADDRESS:2616 GOSFORD ROADTELEPHONE:
(661) 834-1074
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93309
CAPACITY: 118TOTAL ENROLLED CHILDREN: 0CENSUS: 30DATE:
09/17/2021
TYPE OF VISIT:Case Management - COVID-19UNANNOUNCEDTIME BEGAN:
12:25 PM
MET WITH:Assistant Director, Ashley HerreraTIME COMPLETED:
02:05 PM
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On 09/17/2021, Licensing Program Analyst (LPA) Jose Penate conducted a case management inspection with Assistant Director (AD), Ashley Herrera. LPA toured the facility and took a census. The purpose of the case management inspection was to discuss Community Care Licensing (CCL) regulations and COVID-19 recommendations and guidelines.

LPA discussed with AD the importance of following all California Department of Public Health (CDPH), California Department of Social Services (CDSS), and local Public Health Department (PHD) COVID-19 guidelines and recommendations, including the following: Providers must implement screening procedures for all staff and children before entering the facility. Ask all individuals about COVID-19 symptoms within the last 24 hours and whether anyone in their home has had COVID-19 symptoms or a positive test.

LPA also reminded AD to contact Community Care Licensing (CCL) regarding any exposures to COVID-19 or any positive COVID-19 test results for anyone having contact at home or at the center.

AD confirmed that all requirements and guidelines are being followed at the facility. Facility thoroughly cleans the facility throughout the day and when children are not present. Facility uses disinfectant supplies to kill all germs on all items that are used by children in care. Children over the age of 2yrs old enter the facility and throughout the day they are encouraged to continue using the mask. All parents that enter the facility utilize a mask and if one is needed for any parent or child one is handed to them by the facility staff.

Per California Code of Regulations, Title 22, Division 12, no deficiencies were found.

Exit interview was conducted with Assistant Director, Ashley Herrera.

A Notice of Site Visit form (LIC 9213) and a copy of the Facility Evaluation Report (LIC 809) were left with AD.

SUPERVISORS NAME: Duane Matsubara
LICENSING EVALUATOR NAME: Jose Penate
LICENSING EVALUATOR SIGNATURE: DATE: 09/17/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/17/2021
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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