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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343624029
Report Date: 09/18/2024
Date Signed: 09/18/2024 06:07:38 PM

Document Has Been Signed on 09/18/2024 06:07 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 ACADEMY INC.FACILITY NUMBER:
343624029
ADMINISTRATOR/
DIRECTOR:		PERKINS, SUSANFACILITY TYPE:
830
ADDRESS:3100 MACON DRTELEPHONE:
(916) 665-0274
CITY:SACRAMENTOSTATE: CAZIP CODE:
95835
CAPACITY: 40TOTAL ENROLLED CHILDREN: 40CENSUS: 25DATE:
09/18/2024
TYPE OF VISIT:Annual/RequiredUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:00 AM
MET WITH:Mornen HaymerTIME VISIT/
INSPECTION COMPLETED:
06:15 PM
NARRATIVE
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On Wednesday 18 September 24 at approximately 10:00am Licensing Program Analysts (LPAs) Fabian Schwartz and Erwina Pascual-Golamco met with Director, Mornen Haymer, for an unannounced annual and complaint investigation inspection. The purpose of the inspection was explained. At time of inspection, there were 25 Infants supervised by 5 staff and the Director, however, over course of inspection, staff and children numbers fluctuated. Facility was operating within the capacity and in compliance with staff child ratio on this day for this License of the facility. Facility operates day care from Monday – Friday 7am-6pm.

During inspection, LPAs inspected the classrooms, bathrooms, and play yard. Facility has smoke alarms, fire pull alarms, carbon monoxide detectors, fully charged fire extinguishers, first aid supplies, and working telephone at the site. LPAs observed facility has age-appropriate furniture. Furniture is steady and in good repair. Facility has sufficient amount of cribs. Facility floor is in good repair and free of any hazards. All of the cleaning solutions, poisons, and other chemicals that are dangerous to children are inaccessible to children. All toilets and hand washing facilities are in working condition with proper sanitation in place. Storage containers for solid waste are in good repair and have proper lid on top. Facility has drinking water available for children. Play yard is free of hazards. Play structures are steady, in good repair, and free of any loose parts. There is a sufficient amount of turf material under the play structures to prevent any fall injuries. LPAs observed the facility has drinking water available for children in play yard.

LPAs reviewed the facility records. LPAs observed that facility has license and other required documents posted and visible for public. Facility is using electronic sign in / out. LPAs reviewed 5 random children's and 5 staff’s files. During Staff file review, LPAs observed 50% of staff files reviewed did not have Mandated Reporter Certificates or LIC503 forms on record. LPAs observed facility has record of names, addresses, and telephone numbers of each child's authorized representative and record required immunization of each child on file. The facility conducts emergency drills and has a log in place. 2 staff members have current CPR training certificates on file. Continued on LIC809-C……
SUPERVISORS NAME: Amanda Blesi
LICENSING EVALUATOR NAME: Fabian Schwartz
LICENSING EVALUATOR SIGNATURE: DATE: 09/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/18/2024
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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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 INC.
FACILITY NUMBER: 343624029
VISIT DATE: 09/18/2024
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Report Continued from previous LIC809......................

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.

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. LPA referred facility representative to the Department website for lead: Lead Toxicity Prevention and Water Testing Information

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. When any IMS is provided, an updated Plan of Operation that includes IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-care-centers/.

2 Type B Title 22 deficiencies were cited during today's inspection for Lack of Mandated Reporter Training and LIC503 forms in staff files. Deficiencies explained more on following LIC809-D page. A copy of this report was reviewed and provided to the facility representative. Notice of site visit is posted and shall remain posted for next 30 days.
SUPERVISORS NAME: Amanda Blesi
LICENSING EVALUATOR NAME: Fabian Schwartz
LICENSING EVALUATOR SIGNATURE:

DATE: 09/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/18/2024
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 09/18/2024 06:07 PM - It Cannot Be Edited


Created By: Fabian Schwartz On 09/18/2024 at 04:50 PM
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 INC.
FACILITY NUMBER: 343624029

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/18/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101216(g)(2)
Personnel Requirements
(2) Each person specified in (g) above shall have a health-screening report signed by the person performing the screening. This report shall indicate the following:

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 by having 50% of staff files not have a completed LIC503 Health Screening which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 10/18/2024
Plan of Correction
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Director will email LPA evidence of staff completing LIC503 by 18 October 24.
Type B
Section Cited
HSC
1596.8662(b)(1)
Administration of Child Day Care Licensing
(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on interview and record review, the licensee did not comply with the section cited above by not having current Mandated Reporter Trainings in 3/8 staff's files which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 10/18/2024
Plan of Correction
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Director will email LPA staff's completed Mandated Reporter Certificates by 18 October 24.
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:Amanda Blesi
LICENSING EVALUATOR NAME:Fabian Schwartz
LICENSING EVALUATOR SIGNATURE:
DATE: 09/18/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/18/2024


LIC809 (FAS) - (06/04)
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