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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 313608509
Report Date: 05/08/2024
Date Signed: 05/08/2024 12:26:14 PM

Document Has Been Signed on 05/08/2024 12:26 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
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:LA PETITE ACADEMYFACILITY NUMBER:
313608509
ADMINISTRATOR/
DIRECTOR:		MEGAN ORTOLIVOFACILITY TYPE:
830
ADDRESS:5820 STANFORD RANCH ROADTELEPHONE:
(916) 624-4816
CITY:ROCKLINSTATE: CAZIP CODE:
95765
CAPACITY: 24TOTAL ENROLLED CHILDREN: 24CENSUS: 16DATE:
05/08/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:05 AM
MET WITH:Megan OrtolivoTIME VISIT/
INSPECTION COMPLETED:
12:30 PM
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Licensing Program Analyst (LPA) Jeremey McClain met with facility representative Megan Ortolivo for an unannounced required annual random inspection. LPA observed care and supervision of 16 infants by 6 staff in separate classrooms.
LPA inspected all activity and classroom spaces, restrooms, food service, and outdoor play areas. Hazardous items are inaccessible to children. Furniture and equipment are in operable and safe condition. Playground equipment and surfaces are free of loose or sharp parts, and adequate cushioning was observed in areas underneath climbing equipment. Toileting facilities are in safe, sanitary, and operating condition. The floors appeared clean throughout the facility. The food preparation space is free of litter and all food was protected against contamination. Storage containers with solid waste have tight-fitting covers in each classroom. Facility representative stated that no children in care require medications. LPA observed a functional carbon monoxide detector.
Infant changing tables have a padded surface that is washable and at least one-inch-thick, and the changing tables have raised sides that are at least three inches high. The floors appeared clean throughout the facility. LPA observed appropriate napping equipment for each infant in care. Cribs were equipped with appropriate fitting mattresses, tight fitting covers, and were free of loose articles and objects, including blankets and pillows.
LPA observed documented 15-minute sleep checks. Infant bottles were labeled with the date and child’s name. 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-and-resources/safe-sleep as an additional resource. LPA also informed licensee [or facility representative] 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.
Morning and afternoon snacks, and lunch are provided by the facility. LPA observed posted menus showing planned meals at least one week in advance. Continued...
SUPERVISORS NAME: Keven Peters
LICENSING EVALUATOR NAME: Jeremey McClain
LICENSING EVALUATOR SIGNATURE: DATE: 05/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/08/2024
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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Document Has Been Signed on 05/08/2024 12:26 PM - It Cannot Be Edited


Created By: Jeremey McClain On 05/08/2024 at 11:11 AM
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
, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: LA PETITE ACADEMY
FACILITY NUMBER: 313608509

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/08/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101419.2(a)
Infant Needs and Services Plan
(a) Prior to the infant's first day at the center, the infant care center director or assistant director shall complete a needs and services plan for the infant.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above in count out of two infants, which poses a potential health, safety or personal rights risk to persons in care. LPA did not observe needs and services plan for C1 and C2 during record review.
POC Due Date: 05/31/2024
Plan of Correction
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Director will obtain completed and signed needs and services plans for C1 and C2 by the POC due date 05/31/2024. Proof shall be sent to LPA by the POC due date, or LPA will return to conduct record review.
Type B
Section Cited
CCR
101419.2(b)(2)
Infant Needs and Services Plan
(b) The needs and services plan shall be in writing and shall include the following: (2) Infants up to 12 months of age shall have a completed Individual Infant Sleeping Plan [LIC 9227 (3/20)], which is incorporated by reference.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above as LPA did not observe an LIC 9227 for C1, which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 05/31/2024
Plan of Correction
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Director will have a completed LIC 9227 for C1 by the POC due date. Proof shall be sent to LPA or LPA will return to conduct record review.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Keven Peters
LICENSING EVALUATOR NAME:Jeremey McClain
LICENSING EVALUATOR SIGNATURE:
DATE: 05/08/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/08/2024


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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
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: LA PETITE ACADEMY
FACILITY NUMBER: 313608509
VISIT DATE: 05/08/2024
NARRATIVE
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 Noncontaminated Drinking water is readily available to children both indoors and outdoors.
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.
The facility currently utilizes and electronic sign in and out sheet. LPA reviewed records for all present staff. At least one staff member present today has current Pediatric CPR and First Aid certification which expires 2/2026. All staff currently employed with the facility have: a criminal record clearance, a health screening report, immunization records, current AB1207 Mandated Reporter Training, and documentation of their educational background, training, and/or experience.
Two children records were reviewed. Each child's file contained a completed emergency contact form, immunization records, signed personal rights form, and a completed medical assessment.
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.
All individuals subject to criminal record review have obtained clearance. Facility representative 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.

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.

Deficiencies are documented on the following page of this report. A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the facility representative Megan Ortolivo.
SUPERVISORS NAME: Keven Peters
LICENSING EVALUATOR NAME: Jeremey McClain
LICENSING EVALUATOR SIGNATURE:

DATE: 05/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/08/2024
LIC809 (FAS) - (06/04)
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