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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197401076
Report Date: 06/24/2026
Date Signed: 06/24/2026 02:05:14 PM

Document Has Been Signed on 06/24/2026 02:05 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 CC RO, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME:LA PETITE ACADEMY INC.FACILITY NUMBER:
197401076
ADMINISTRATOR/
DIRECTOR:		COURSON, JEANAFACILITY TYPE:
830
ADDRESS:1709 E. PALMDALE BLVD.TELEPHONE:
(661) 272-3708
CITY:PALMDALESTATE: CAZIP CODE:
93550
CAPACITY: 24TOTAL ENROLLED CHILDREN: 24CENSUS: 12DATE:
06/24/2026
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:56 AM
MET WITH:Angie Bustamante, DirectorTIME VISIT/
INSPECTION COMPLETED:
02:15 PM
NARRATIVE
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On June 24, 2026, Licensing Program Analyst (LPA) Crystal Ali met with Director, Angie Bustamante for the purpose of an unannounced Annual/Random inspection. LPA disclosed the purpose of the inspection and was granted entry to the facility. Upon arrival, LPA observed one infant classroom and the teacher/child ratios are in compliance. LPA observed 12 infants and 3 teachers, Team Lead, Assistant Director, and Director present during this inspection. Infant area consist of one classroom and one play yard area. The center also has a school age program (197401075) and a daycare program (197401074). LPA observed all staff to have an approved background criminal record clearance through Guardian. The facility hours of operation are from 6:30 am to 6:00 pm, Monday-Friday. Incidental Medical Services (IMS) were discussed. There are no infants with IMS needs. Director states there is no weapons or smoking the premises.

Staffing Ratio and Capacity: Upon arrival, LPA observed one infant classroom in use with a total of 18 enrolled. Care and supervision were evaluated to determine if the children’s basic needs were met and appropriate. Sign-in and out sheets were reviewed in the Sproutabout App.
NAME OF LICENSING PROGRAM MANAGER: Francisco Pedroza
NAME OF LICENSING PROGRAM ANALYST: Crystal Ali
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 06/24/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/24/2026
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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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
PALMDALE CC RO, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: LA PETITE ACADEMY INC.
FACILITY NUMBER: 197401076
VISIT DATE: 06/24/2026
NARRATIVE
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Physical Plant: LPA toured and inspected the daycare classrooms. Furniture and equipment were checked for age appropriateness and good repair. The classroom is clean and safe. All adults that enter the infant classroom must wear covering on their shoes. Telephone service was verified. Heating, lighting, and ventilation are adequate. There are cubbies for infant’s belongings labeled with their names. Facility has a surveillance system on the premises in common areas, live stream only. LPA observed age-appropriate toys and materials. Daily activities schedule was observed on the wall in each daycare classroom. Facility provides diapers, wipes, formula, and baby food. If parents want to bring their infants own food they must fill out a form requesting to bring their own for their child. All containers used for storage of solid wastes, including moveable bins, shall have a tightfitting cover that is kept on; they shall be leakproof and rodent-proof. LPA observed trash cans in classroom, kitchen and play yard to all have lids.

Napping: LPA observed nap time. There are 6 cribs and cots for the infants to nap on. Cots are used for children who are too large for the crib. Staff sanitized the cots after each use. Older infants bring their blankets.

Bathroom: LPA observed changing station that is next to sink that meet regulation requirements. Staff bathroom is located in the Twos 2 classroom. LPA observed soap, toilet paper, and paper towels readily available.

Medication: Infant are inspected for illnesses as they arrive with a no-touch thermometer and an overall wellness check. A review of medication policy indicated that prescription medication is administered only with the parent’s written permission.

NAME OF LICENSING PROGRAM MANAGER: Francisco Pedroza
NAME OF LICENSING PROGRAM ANALYST: Crystal Ali
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 06/24/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/24/2026
LIC809 (FAS) - (06/04)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
PALMDALE CC RO, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: LA PETITE ACADEMY INC.
FACILITY NUMBER: 197401076
VISIT DATE: 06/24/2026
NARRATIVE
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The staff will administer medication and document the dosage, date, and time on a log. Medication is brought and safety latched at the center (unless the parent requests daily return). Medication is labeled correctly and stored in its original container. Medication is kept in director office in locked box until expiration and sent home with the parent for disposal. Director states there are no infants on medication and no food allergies. Infant are isolated when ill by placing away from other children in infant classroom until parents arrive to pick them up.
Lead Water Testing: Lead water testing as completed and approved on 8/26/22. Next, lead water testing to be completed by 8/26/27.
The Outdoor: The play equipment was inspected for health, safety, cushioning material, good repair, and age appropriateness. LPA observed small play equipment and several other toys. There is one shaded area outside. The play area was inspected and found to be free of inaccessibility to bodies of water. Director states that play yard area is power washed once a year, Teachers clear any debris daily, and pest control comes every once a month for the outside. LPA observed the following needing repairs in infant play yard: two small holes in the privacy screen, the bottom of fence (two sections) is rusted and exposed the cushion flooring. Director states staff ensure 100% supervision at all times. The facility has a separate fenced playground yard for school age and daycare children.
Fire Extinguisher: Fire/earthquake drills are current and completed every 6 months. Last fire drill/disaster drill completed on 5/20/26. Fire extinguishers are in the green located at each exit (service last service 4/6/26), inaccessible to children mounted on the walls at entrance, exits and bathrooms. Smoke detector, and carbon monoxide detector are on the premises and in compliance with fire marshal standards. Director informed
NAME OF LICENSING PROGRAM MANAGER: Francisco Pedroza
NAME OF LICENSING PROGRAM ANALYST: Crystal Ali
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 06/24/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/24/2026
LIC809 (FAS) - (06/04)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
PALMDALE CC RO, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: LA PETITE ACADEMY INC.
FACILITY NUMBER: 197401076
VISIT DATE: 06/24/2026
NARRATIVE
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Transportation: The facility does not provide transportation.
Kitchen/Food Service: The kitchen is off-limits by locked door. There is a clean, fully equipped kitchen with a refrigerator, freezer, stove, and microwave oven. Parents provide formula for their children. Knives are located in the top left drawer to the right. Allergy lists are posted in the refrigerator. No infants with food allergies. Director states that some parents have preferences on the type of milk provided and we try to accommodate them. Soaps, detergents, cleaning compounds, or similar substances are stored separately from food supplies. The chemicals are kept separate from the food (under the sink). LPA observed that food preparation and storage areas are kept clean and free of litter and rubbish. Menus are posted at least one week in advance and made available for review by the parents. The facility does participate in the CACFP food program, last inspected on 6/2/26. Director states that they order food weekly for the facility that gets delivered on Wednesdays.
Staff/ Children Records: LPA reviewed with licensee the LIC 126, records to be maintained at the facility, for child’s records, personnel records, administrative records, and parent board. Staff and children records were reviewed. LPA reviewed 3 infant's records and 4 staff records. LPA observed staff records to be out of compliance. LPA observed two staff records that do not have a current valid mandated reporter certification. One Type B deficiency was issued. Director stated she will have staff complete the mandated reporter training and will provide proof of completion to LPA. LPA observed 3 infant records in compliance.
NAME OF LICENSING PROGRAM MANAGER: Francisco Pedroza
NAME OF LICENSING PROGRAM ANALYST: Crystal Ali
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 06/24/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/24/2026
LIC809 (FAS) - (06/04)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
PALMDALE CC RO, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: LA PETITE ACADEMY INC.
FACILITY NUMBER: 197401076
VISIT DATE: 06/24/2026
NARRATIVE
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To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at
www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

Criminal Record Clearance - Child Care Centers
Director was reminded that all adults 18 and over, including
employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

Lead Testing – Child Care Centers (CCC)
CCC COMPLETED TESTING AND NO LEAD EXCEEDANCES:
Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care
Centers (CCCs) constructed before January 1, 2010, to test their water (used for
drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test. For child care center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1-CCP). LPA verified that the lead testing was completed in accordance to the Written Directives
outlined in PIN 21-21.1-CCP.
NAME OF LICENSING PROGRAM MANAGER: Francisco Pedroza
NAME OF LICENSING PROGRAM ANALYST: Crystal Ali
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 06/24/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/24/2026
LIC809 (FAS) - (06/04)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
PALMDALE CC RO, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: LA PETITE ACADEMY INC.
FACILITY NUMBER: 197401076
VISIT DATE: 06/24/2026
NARRATIVE
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Safe Sleep - Child Care Centers
LPA discussed the safe sleep regulations with facility representative and
discussed the Child Care Licensing Safe Sleep webpage at
https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep as an additional resource. LPA also informed facility
of the importance of checking for recalled infant devices on the United States
Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and
recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.
Incidental Medical Services (IMS) - Child Care Centers
Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. When any IMS is provided, an updated Plan of Operation that includes IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-care-centers/.
PIN 22-05-CCP
MyChildCarePlan.org – Child Care Centers
Facility representative was informed of the MyChildCarePlan.org website; a
consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.
NAME OF LICENSING PROGRAM MANAGER: Francisco Pedroza
NAME OF LICENSING PROGRAM ANALYST: Crystal Ali
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 06/24/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/24/2026
LIC809 (FAS) - (06/04)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
PALMDALE CC RO, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: LA PETITE ACADEMY INC.
FACILITY NUMBER: 197401076
VISIT DATE: 06/24/2026
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Subscribe to CCLD important information - Child Care Centers
Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platforms. To receive important licensed related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-carelicensing/
subscribe and select the Child Care option to receive email communication.

Deficiencies cited: (see LIC809D) One Type B in accordance with Title 22 of the California Code of Regulations and Health & Safety codes.

Exit interview conducted and report was reviewed with the Director, Angie Bustamante.

NAME OF LICENSING PROGRAM MANAGER: Francisco Pedroza
NAME OF LICENSING PROGRAM ANALYST: Crystal Ali
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 06/24/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/24/2026
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 06/24/2026 02:05 PM - It Cannot Be Edited


Created By: Crystal Ali On 06/24/2026 at 01:39 PM
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
, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: LA PETITE ACADEMY INC.
FACILITY NUMBER: 197401076

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/24/2026

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1596.8662(b)(1)
Administration of Child Day Care Licensing
(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, interview, record review, the licensee did not comply with the section cited above in having a valid mandated reporter training for S1 and S2 which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 06/26/2026
Plan of Correction
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Director states she will have staff complete the mandated reporter training and will send proof of completion to LPA Ali via email.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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.
Francisco Pedroza
NAME OF LICENSING PROGRAM MANAGER:
Crystal Ali
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 06/24/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/24/2026


LIC809 (FAS) - (06/04)
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