343624030-9-9-2021-03-CC-MLOR-C6Q28Y-20210909171108

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 343624030
Report Date: 09/09/2021
Date Signed: 09/09/2021 05:11:15 PM

Document Has Been Signed on 09/09/2021 05:11 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
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833

FACILITY NAME:	LA PETITE ACADEMY INC. (PS)		FACILITY NUMBER:	343624030
ADMINISTRATOR:	SUSAN PERKINS		FACILITY TYPE:	850
ADDRESS:	3100 MACON DR		TELEPHONE:	(916) 665-0274
CITY:	SACRAMENTO	STATE: CA	ZIP CODE:	95835
CAPACITY: 92	TOTAL ENROLLED CHILDREN: 0	CENSUS:	DATE:	09/09/2021
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME BEGAN:	01:00 PM
MET WITH:	Teresa Addison and Tracy Mote		TIME COMPLETED:	05:20 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	Application Specialist (AS) Mai Lor and Licensing Program Analyst (LPA) Michelle Pascual met with Applicant Teresa Addison and Operation Integration Support Specialist (OISS) Tracy Mote for the purpose of an announced prelicensing change of ownership inspection. This is a change of ownership from Prestige Preschool Academy (#343616168). Applicant requests a preschool license to serve 192 preschool children from age two to entry into first grade. Census included 55 children and 5 staff. The program will operate Monday through Friday from 6:30 AM to 6:00 PM. The fire clearance was granted on 7/21/2021. Applicant acknowledges that the following documents must be posted at all times: License, Emergency Disaster Plan, Personal Rights, Parents' Rights Poster, car seat law, Effects of Lead Exposure brochure, menus, and daily schedule. AS discussed the forms that must be in each child's and each staff member's file. The facility will provide lunch and snacks. INDOOR ACTIVITY SPACE: There are nine classrooms: Classrooms #4 through #11 and #14. AS and LPA observed a sufficient amount of equipment, toys, tables, and cubbies. TAS and LPAs observed a sufficient amount of equipment, toys, tables, chairs, and cubbies. There is a first aid kit in each classroom and the office. AS and LPA observed cleaning disinfectants are appropriately stored and inaccessible to children. Applicant stated medications will be stored in the office. Applicant stated there are no poisons or firearms on the premises. Applicant stated there will be pitchers and water cups available in each classroom. AS and LPA observed a carbon monoxide detector in the hallway. Applicant stated the facility will use an electronic sign-in/sign-out system. (Report continues on subsequent LIC 809)

SUPERVISORS NAME: Roxana Saravia
LICENSING EVALUATOR NAME: Mai Lor
LICENSING EVALUATOR SIGNATURE:	DATE: 09/09/2021

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/09/2021

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, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833

FACILITY NAME: LA PETITE ACADEMY INC. (PS)	FACILITY NUMBER: 343624030
	VISIT DATE: 09/09/2021

NARRATIVE

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AS and LPA measured the classrooms. The total classroom space contains a total of 7730.088 square feet, which accommodates the request for 192 preschool children. There are 25 toilets and 33 sinks for the children, and two separate private restrooms for the staff. Individual measurements are recorded on the Capacity Worksheet (LIC 9024). Children who become ill during the day will be isolated in the office and will use the staff restroom, if necessary.

OUTDOOR ACTIVITY SPACE:
There are three outdoor areas for preschool. The outdoor play area is surrounded by chained link fence that is at least four feet tall. The preschool yard is separated from the infant and school age yard by chained link fence. Applicant request to share two of the three preschool outdoor areas with the school age children. Applicant will submit a shared playground waiver request to AS prior to licensure. AS and LPA observed a sufficient amount of equipment and toys. There are shaded areas supplied by shade structures . Applicant acknowledges staff must ensure children use age-appropriate equipment at all times.

AS and LPA measured the outdoor activity space. The outdoor play area contains a total of 19024.88 square feet, which will accommodate Applicant's request for 192 preschool children. Individual measurements are recorded on the Capacity Worksheet (LIC 9024).

AS discussed the following: 100% supervision is required at all times; personal rights; inspection authority; reporting requirements; staff to children ratios and capacity; staff qualifications; and maintaining buildings and grounds. AS discussed with Applicant any changes that may occur regarding the director or an employee acting in the director's absence must be reported to department within 10 working days.

The facility's Plan of Operation is located in the preschool file.

AS will email LIC311A, Effects of Lead Exposure brochure and Provider Notice Information (PIN) 21-21 (Release of the Written Directives for Lead Testing of Water in Licensed Child Care Centers per AB 2370), and immunization card. AS and LPA reviewed lead testing requirement and COVID-19 technical assistance with the applicant.

(Report continues on subsequent LIC 809)

SUPERVISORS NAME: Roxana Saravia
LICENSING EVALUATOR NAME: Mai Lor
LICENSING EVALUATOR SIGNATURE:	DATE: 09/09/2021

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/09/2021

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, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833

FACILITY NAME: LA PETITE ACADEMY INC. (PS)	FACILITY NUMBER: 343624030
	VISIT DATE: 09/09/2021

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This facility plans to provide Incidental Medical Services - IMS. For IMS information, see Evaluator Manuel - Regulation Interpretations and Procedures for Child Care Centers Section 101173 and 101226. A 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)/(800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

To improve the quality and value of the new inspection process, a survey will 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 tools, please send them by email 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.

Licensee was reminded that all adults 18 and over, including employees and volunteers, 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 up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

Licensee was encouraged to visit the Department website at WWW.CCLD.CA.GOV for child care updates, current forms, legislation and regulation information. A copy of this report will remain on file for a period of three years for public review upon request.

The following items are required before a license will be issued:

1. Final Licensing Program Manager's review

2. Job Description

Exit interview conducted and report was reviewed with applicant Teresa Addison and OISS Tracy Mote.

SUPERVISORS NAME: Roxana Saravia
LICENSING EVALUATOR NAME: Mai Lor
LICENSING EVALUATOR SIGNATURE:	DATE: 09/09/2021

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/09/2021

LIC809 (FAS) - (06/04)

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