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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 334801127
Report Date: 04/12/2022
Date Signed: 04/12/2022 09:54:13 AM

Document Has Been Signed on 04/12/2022 09:54 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME:LA PETITE ACADEMYFACILITY NUMBER:
334801127
ADMINISTRATOR:KELLIE BARELAFACILITY TYPE:
850
ADDRESS:6212 CLAY STREETTELEPHONE:
(951) 681-3783
CITY:RIVERSIDESTATE: CAZIP CODE:
92509
CAPACITY: 114TOTAL ENROLLED CHILDREN: 114CENSUS: 64DATE:
04/12/2022
TYPE OF VISIT:Case Management - COVID-19UNANNOUNCEDTIME BEGAN:
09:42 AM
MET WITH:Kellie Barela, DirectorTIME COMPLETED:
10:00 AM
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Due to COVID-19 on 04/12/2022 Licensing Program Analyst (LPA), Giselle Carbullido conducted a second Case Management inspection to provide technical assistance. A prior visit was completed on 04/05/22 and due to technical difficulties did not register in the system. In January 2022 the facility had a COVID-19 outbreak resulting in the closure of the facility each time. LPA Carbullido met with Director, Kellie Barela toured the facility and census was taken.

During the inspection, LPA reviewed and discussed COVID-19 guidelines, resources, and postings with Director. COVID-19 information posters including hand-washing posters were observed in child care areas and bathroom. The licensee was advised to follow the child care industry guidelines on face coverings, sanitation and other infection prevention measures.

During today’s inspection the following resources were discussed and provided:

· Community Care Licensing Division’s COVID 19 Information and Resources: https://www.cdss.ca.gov/inforesources/community-care-licensing

· CDPH’s Guidance for Child Care Providers and Programs - updated June 29, 2021: www.cdph.ca.gov/Programs/CID/DCDC/Pages/COVID-19/Child-Care-Guidance.aspx

· Cal-OSHA - revisions are effective starting on January 17, 2022: https://www.dir.ca.gov/dosh/coronavirus/ETS.html
SUPERVISORS NAME: Gilbert Sena
LICENSING EVALUATOR NAME: Giselle Carbullido
LICENSING EVALUATOR SIGNATURE: DATE: 04/12/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/12/2022
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME: LA PETITE ACADEMY
FACILITY NUMBER: 334801127
VISIT DATE: 04/12/2022
NARRATIVE
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1)California Department of Public Health
a. Guidance for Face Coverings
i. Released on July 28, 2021; Updated February, 7, 2022
b. https://www.cdph.ca.gov/Programs/CID/DCDC/Pages/COVID-19/guidance-for-face-coverings.aspx

2) https://www.cdph.ca.gov/Programs/CID/DCDC/Pages/COVID-19/Face-Coverings-QA.aspx

· Local Public Health Information:
· Riverside County Public Health:
Tel: (951) 358-5000
Website: https://www.rivcoph.org/

· San Bernardino County Public Health
Tel: (909) 381-8990
Website: http://wp.sbcounty.gov/dph/

· Local Resource and Referral Agencies:
§ Riverside County Office of Education (RCOE):
Tel: (800) 442-4927
Website: https://www.rcoe.us/departments/early-learning-services/early-care-and-education

§ Child Care Resource Center (CCRC):
Tel: (909) 384-8000
Website: https://www.ccrcca.org/

· To report an Unusual Incident Report (UIR), please fax/scan a completed UIR form (within 24 hours of incident occurring), to the Unusual Incident Reporting email mailbox: UnusualIncidentReportsDO09@dss.ca.gov or fax to 951-782-4985.
SUPERVISORS NAME: Gilbert Sena
LICENSING EVALUATOR NAME: Giselle Carbullido
LICENSING EVALUATOR SIGNATURE:

DATE: 04/12/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/12/2022
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
CCLD Regional Office, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME: LA PETITE ACADEMY
FACILITY NUMBER: 334801127
VISIT DATE: 04/12/2022
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· FORMS: LIC624 (Child Care Center)

· Complete notification to CDSS Duty Officer at 951-782-4200

· In addition, Provider Information Notices (PINs) and other resources regarding COVID-19 can be found on our website at: www.cdss.ca.gov

No deficiency was cited during this inspection.

An exit interview was conducted with Director Kellie Barela. LPA provided licensee with a copy of this report and a Notice of Site Visit.
SUPERVISORS NAME: Gilbert Sena
LICENSING EVALUATOR NAME: Giselle Carbullido
LICENSING EVALUATOR SIGNATURE:

DATE: 04/12/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/12/2022
LIC809 (FAS) - (06/04)
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