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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197409418
Report Date: 04/10/2024
Date Signed: 04/10/2024 03:20:31 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
PALMDALE CC RO, 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
03/19/2024 and conducted by Evaluator Mayra Rivera
PUBLIC
COMPLAINT CONTROL NUMBER: 12-CC-20240319151121
FACILITY NAME:LA PETITE ACADEMYFACILITY NUMBER:
197409418
ADMINISTRATOR:ASHLEY PEREZFACILITY TYPE:
830
ADDRESS:28041 SECO CANYON ROADTELEPHONE:
(661) 297-0977
CITY:SAUGUSSTATE: CAZIP CODE:
91350
CAPACITY:16CENSUS: 9DATE:
04/10/2024
UNANNOUNCEDTIME BEGAN:
01:10 PM
MET WITH:Maria Goldman, DirectorTIME COMPLETED:
02:30 PM
ALLEGATION(S):
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Staff did not prevent a child from throwing a toy at an infant in care.
Facility staff are not following safe sleep guidelines.
INVESTIGATION FINDINGS:
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On Wednesday, April 10, 2024, at 1:10 p.m., Licensing Program Analyst (LPA), Mayra Rivera conducted an unannounced complaint inspection and delivered findings regarding Staff did not prevent a child from throwing a toy at an infant in care and facility staff are not following safe sleep guidelines. Upon arrival, LPA toured the facility. LPA entered infant classroom and observed one infant napping in the crib and the other infant awake on the floor mat and one staff providing care and supervision. LPA entered toddler classroom and observed 7 toddlers napping and one awake with two staff providing care and supervision.

Based on observation, confidential interviews conducted, and documentation reviewed did not support nor confirm the above allegations. This agency has investigated the complaint alleging staff did not prevent a child from throwing a toy at an infant in care and facility staff are not following safe sleep guidelines. On 3/21/24 and 4/10/24 LPA Rivera observed 2 infants napping in the cribs and the ipad 15 minute alarm to notify staff to document the 15 min sleep log. During the interviews it was disclosed no concerns with the quality of care provided at La Petite and toy was not thrown at the infant.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Mayra Rivera
LICENSING EVALUATOR SIGNATURE:

DATE: 04/10/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/10/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 3
Control Number 12-CC-20240319151121
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION 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
FACILITY NUMBER: 197409418
VISIT DATE: 04/10/2024
NARRATIVE
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At this time, it is determined that although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore at this time the above allegation is unsubstantiated. No deficiency given at this time.

Exit interview was conducted with Director Maria Goldman. The licensee was provided a copy of their appeal rights (LIC 9058) and their signature on this form acknowledges receipt of these forms.
SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Mayra Rivera
LICENSING EVALUATOR SIGNATURE:

DATE: 04/10/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/10/2024
LIC9099 (FAS) - (06/04)
Page: 3 of 3