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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 344500454
Report Date: 03/10/2025
Date Signed: 03/10/2025 02:26:38 PM

Document Has Been Signed on 03/10/2025 02:26 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 S. CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:LA PETITE ACADEMYFACILITY NUMBER:
344500454
ADMINISTRATOR/
DIRECTOR:		SANCHEZ, ASHLEYFACILITY TYPE:
850
ADDRESS:8160 SHELDON ROADTELEPHONE:
(916) 684-4222
CITY:ELK GROVESTATE: CAZIP CODE:
95758
CAPACITY: 168TOTAL ENROLLED CHILDREN: 168CENSUS: 54DATE:
03/10/2025
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:00 AM
MET WITH:Ashley SanchezTIME VISIT/
INSPECTION COMPLETED:
03:30 PM
NARRATIVE
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On 03/10/2025, Licensing Program Analyst Katy Velazquez (LPA) conducted a field visit to the facility for a case management inspection. LPA arrived at the center and was met by Director Sanchez (D1). LPA disclosed the purpose of the inspection and was granted entrance into the facility. LPA conducted a tour of the facility and observed 54 preschool aged children being supervised by 7 staff members. LPA determined, through accessing Guardian, that 1 staff member (who was providing care and supervision to children in a preschool classroom) was not associated to the facility's preschool license.
A Type-A deficiency was cited on a subsequent 9099-D page. D1 acknowledges, that FOR TYPE A DEFICIENCIES ONLY upon receipt, licensee shall post LIC 9099-D with Type A deficiencies for 30 days and provide copies of this licensing report to parents/guardians of children in care at the facility and to parents/guardians of children newly enrolled at the facility during the next 12 months. LIC 9224 must be signed by parents/guardians and kept with the children's forms as a receipt whenever any Type A document(s) are provided by the licensee.
D1 transferred the staff members background check to the preschool license at 11:55 AM on 03/10/2025. LPA verified this association by accessing Guardian. LPA cleared the Type A citation on site and provided D1 with a letter of clearance.
An exit interview was conducted and the report was reviewed with Director Sanchez. LPA provided Licensee Appeal Rights to D1. A Notice of Site visit was posted by LPA and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
SUPERVISORS NAME: Karyn Guerra
LICENSING EVALUATOR NAME: Katy Velazquez
LICENSING EVALUATOR SIGNATURE: DATE: 03/10/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/10/2025
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 03/10/2025 02:26 PM - It Cannot Be Edited


Created By: Katy Velazquez On 03/10/2025 at 02:16 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
FACILITY NUMBER: 344500454

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/10/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
03/11/2025
Section Cited
CCR
101216(i)(2)

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(i) Prior to employment or initial presence in the child care center, all employees and volunteers subject to a criminal record review shall:... (2) Request a transfer of a criminal record clearance as specified in Section 101170(f)...This requirement was not met
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Director Sanchez accessed Guardian and transferred T1 to the preschool license. LPA cleared the citation while on location and provided a letter of clearance to D1.
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as evidenced by LPA observing a staff member providing care and supervision to preschool children when the staff member was not associated to the preschool license. This poses/posed 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.
SUPERVISOR'S NAME:Karyn Guerra
LICENSING EVALUATOR NAME:Katy Velazquez
LICENSING EVALUATOR SIGNATURE:
DATE: 03/10/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/10/2025


LIC809 (FAS) - (06/04)
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