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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197401074
Report Date: 09/28/2023
Date Signed: 09/28/2023 12:41:39 PM

Document Has Been Signed on 09/28/2023 12:41 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
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME:LA PETITE ACADEMY INC.FACILITY NUMBER:
197401074
ADMINISTRATOR:JEANA COURSONFACILITY TYPE:
850
ADDRESS:1709 E. PALMDALE BLVD.TELEPHONE:
(661) 272-3708
CITY:PALMDALESTATE: CAZIP CODE:
93550
CAPACITY: 108TOTAL ENROLLED CHILDREN: 108CENSUS: DATE:
09/28/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
12:12 PM
MET WITH:Jeana Courson, DirectorTIME COMPLETED:
12:45 PM
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On September 28, 2023, Licensing Program Analyst (LPA) Annelise Villa met with Director Jeana Courson, who guided LPA on a tour of the facility. The purpose of this visit was to conduct a Case Management - Incident inspection regarding Child #2 (C2) tripping while playing, resulting in Child #1’s (C1) arm breaking. This Unusual Incident was self-reported within the time frame specified by regulations. Upon arrival LPA observed 93 daycare children in care, along with 22 teachers.

Description of incident: On September 11, 2023, C1 and C2 were playing together when C2 tripped and fell on C1 and broke C1's arm.

LPA Villa interviewed staff and children involved. During interviews with staff, it was determined staff were providing adequate care and supervision to all children in care. At this time, the facility took appropriate measures to ensure the health and safety of child #1 and obtained medical treatment in a timely manner.

No deficiencies have been cited at this time.

An exit interview was conducted and a copy of this report was provided to the Director, along with a Notice of Site Visit and her appeal rights.
SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Annelise Villa
LICENSING EVALUATOR SIGNATURE: DATE: 09/28/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/28/2023
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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