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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 343624029
Report Date: 12/21/2023
Date Signed: 12/21/2023 12:40:57 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
This is an official report of an unannounced visit/investigation of a complaint received in our office on
12/19/2023 and conducted by Evaluator Soleil Marx
PUBLIC
COMPLAINT CONTROL NUMBER: 03-CC-20231219085114
FACILITY NAME:LA PETITE ACADEMY INC.FACILITY NUMBER:
343624029
ADMINISTRATOR:PERKINS, SUSANFACILITY TYPE:
830
ADDRESS:3100 MACON DRTELEPHONE:
(916) 665-0274
CITY:SACRAMENTOSTATE: CAZIP CODE:
95835
CAPACITY:40CENSUS: 10DATE:
12/21/2023
UNANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH:Mornen HaymerTIME COMPLETED:
12:50 PM
ALLEGATION(S):
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Staff did not ensure infant's diapering needs were met.
INVESTIGATION FINDINGS:
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Licensing Program Analysts (LPAs) Soleil Marx and Stephanie Piring met with Director, Mornen Haymer, for the purpose of opening and closing a complaint investigation for the above allegation.

It was alleged that staff did not ensure infant's diapering needs were met. Throughout the course of investigation, LPAs conducted observations, reviewed records and documentation, and interviewed staff. It was determined by record review of the daily activity log, that there were no diaper entries logged for an infant during the entire duration of the infants day at the facility. The infant was at the facility from 10:44 AM to 04:25 PM. Staff interview statements confirmed that on December 18th, 2023, an infant did not get their diaper changed for the whole duration of their time at the facility due to miscommunication between staff. The lack of meeting the infants diapering needs resulted in a diaper rash.

Based on LPAs interviews which were conducted and record review, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Natalie Dunaway
LICENSING EVALUATOR NAME: Soleil Marx
LICENSING EVALUATOR SIGNATURE:

DATE: 12/21/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/21/2023
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 4
Control Number 03-CC-20231219085114
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION 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 INC.
FACILITY NUMBER: 343624029
VISIT DATE: 12/21/2023
NARRATIVE
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This facility was previously issued a citation under Title 22 Regulation CCR 101223(a)(2) on 10/10/23, for not being in compliance with personal rights requirements. This is the second citation for the same violation within a 12 month period.

Civil penalties are being assessed in the amount of $250.00 for a repeat violation.

See the attached LIC9099-D for Type A Title 22 Deficiency and LIC421FC for Civil Penalty assessment.

The director was informed that this report dated 12/21/2023 documents one Type A citation which shall be posted for 30 consecutive days. The director shall also provide a copy of this licensing report to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification. Director has been provided with appeal rights.

Exit interview conducted with Director, report was reviewed, and appeal rights were provided. Director received a Notice of Site which must remain posted for 30 days.
SUPERVISORS NAME: Natalie Dunaway
LICENSING EVALUATOR NAME: Soleil Marx
LICENSING EVALUATOR SIGNATURE:

DATE: 12/21/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/21/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 4
Control Number 03-CC-20231219085114
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION 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 INC.
FACILITY NUMBER: 343624029
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/21/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
12/22/2023
Section Cited
CCR
101223(a)(2)
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101223 Personal Rights
(a) The licensee shall ensure that each child is accorded the following personal rights:
(2) To be accorded safe, healthful and comfortable accommodations...to meet his/her needs. This requirement was not met, as evidenced by:
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Director stated staff will be re-trained, new system will be implemented to ensure diapering needs are being met and communicated. Director will pursue staff disciplinary action. Director will submit documentation to LPA Marx by POC due date including staff signatures and materials.
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Based on interviews and record review, the facility did not ensure an infant was accorded safe, healthful, and comfortable accomodations by not meeting an infants diapering needs, which poses an immediate Health, Safety, or Personal Rights risk 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: Natalie Dunaway
LICENSING EVALUATOR NAME: Soleil Marx
LICENSING EVALUATOR SIGNATURE:

DATE: 12/21/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/21/2023
LIC9099 (FAS) - (06/04)
Page: 3 of 4
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
This is an official report of an unannounced visit/investigation of a complaint received in our office on
12/19/2023 and conducted by Evaluator Soleil Marx
PUBLIC
COMPLAINT CONTROL NUMBER: 03-CC-20231219085114

FACILITY NAME:LA PETITE ACADEMY INC.FACILITY NUMBER:
343624029
ADMINISTRATOR:PERKINS, SUSANFACILITY TYPE:
830
ADDRESS:3100 MACON DRTELEPHONE:
(916) 665-0274
CITY:SACRAMENTOSTATE: CAZIP CODE:
95835
CAPACITY:40CENSUS: 10DATE:
12/21/2023
UNANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH:Mornen HaymerTIME COMPLETED:
12:50 PM
ALLEGATION(S):
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Staff are operating out of ratio
INVESTIGATION FINDINGS:
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Licensing Program Analysts (LPAs) Soleil Marx and Stephanie Piring met with Director, Mornen Haymer, for the purpose of opening and closing a complaint investigation for the above allegation. LPAs observed a census of 10 infants being supervised by four staff, in two seperate classrooms. It was alleged that staff are operating out of ratio. Throughout the course of investigation, LPAs conducted observations, reviewed records, and interviewed staff and authorized representatives. LPAs observed both infant classrooms to be in compliance with ratio requirements. LPAs observed live camera footage of infant classrooms that authorized representatives have unlimited access to view at all times. Staff stated classrooms are always in compliance with ratio. Athhorizied representatives did not express any concerns regarding staff to child ratio requirements. LPAs did not obtain any evidence that could prove that the facility is operating out of ratio. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the allegation did or did not occure, therefore the allegation is unsubstantiated. Exit interview conducted with Director, report was reviewed, and appeal rights were provided. Director received a Notice of Site which must remain posted for 30 days.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Natalie Dunaway
LICENSING EVALUATOR NAME: Soleil Marx
LICENSING EVALUATOR SIGNATURE:

DATE: 12/21/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/21/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 4 of 4