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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197401087
Report Date: 01/11/2023
Date Signed: 01/11/2023 02:03:37 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
This is an official report of an unannounced visit/investigation of a complaint received in our office on
01/09/2023 and conducted by Evaluator Joselito DelMundo
COMPLAINT CONTROL NUMBER: 12-CC-20230109135641
FACILITY NAME:LA PETITE ACADEMY INC.FACILITY NUMBER:
197401087
ADMINISTRATOR:ASHLEY PEREZFACILITY TYPE:
850
ADDRESS:28041 SECO CANYONTELEPHONE:
(661) 297-0977
CITY:SAUGUSSTATE: CAZIP CODE:
91350
CAPACITY:93CENSUS: 51DATE:
01/11/2023
UNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Director Maria Rivera GoldmanTIME COMPLETED:
02:30 PM
ALLEGATION(S):
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Physical Plant
INVESTIGATION FINDINGS:
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Licensing Program Analysts (LPAs) Joselito L. Del Mundo and Carol Heath conducted an unannounced complaint investigation on La Petite Academy Inc. in Saugus California. Upon arrival, LPAs met with the Director Maria Rivera Goldman. The purpose of the inspection was to inform the Director that an investigation is being conduct regarding the above allegation. LPAs observed 9 teachers supervising 51 children (8 infants, 12 toddlers, 31 preschoolers). LPAs toured the facility with the Assistant Director Pamela Forman. During the inspection, LPAs obtained facility roster and reviewed two staff files.
Based on observations and interview, it was determined that the facility is unclean and unsanitary.
Based on the information obtained, there is a preponderance of the evidence to prove that the facility failed to meet the reporting requirements. Therefore, the above allegation is substantiated. Appeal Rights were provided and discussed with Director Maria Rivera Goldman.
An exit interview was conducted, and a copy of this report, Appeal Rights, and Notice of the Site Visit were provided to Director Maria Rivera Goldman.

Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Joselito DelMundo
LICENSING EVALUATOR SIGNATURE:

DATE: 01/11/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/11/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
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Control Number 12-CC-20230109135641
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		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: 197401087
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/11/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
01/11/2023
Section Cited
CCR
101238(a)
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Buildings and Grounds 101238 (a) The child care center shall be clean, safe, sanitary and in good repair at all times to ensure the safety and well-being of children, employees and visitors. This requirement was not met as evidence by:
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The facility will be clean and sanitize for the children in care by (24 hours) and submit pictures to LPA.
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Based on LPAs observation and interviews; the toilets are unsanitary, and the walls of the bathroom and items used by children in the bathroom are unsanitary which posed immediate Health, Safety or Personal Rights risks to persons 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.
SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Joselito DelMundo
LICENSING EVALUATOR SIGNATURE:

DATE: 01/11/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/11/2023
LIC9099 (FAS) - (06/04)
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