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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 364801075
Report Date: 07/27/2023
Date Signed: 07/27/2023 03:05:41 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
This is an official report of an unannounced visit/investigation of a complaint received in our office on
05/04/2023 and conducted by Evaluator Kendal Zirbes
PUBLIC
COMPLAINT CONTROL NUMBER: 12-CC-20230504091130
FACILITY NAME:LA PETITE ACADEMYFACILITY NUMBER:
364801075
ADMINISTRATOR:TAMMY ESQUIVELFACILITY TYPE:
850
ADDRESS:14040 BEAR VALLEY ROADTELEPHONE:
(760) 241-4748
CITY:VICTORVILLESTATE: CAZIP CODE:
92392
CAPACITY:118CENSUS: 88DATE:
07/27/2023
UNANNOUNCEDTIME BEGAN:
01:31 PM
MET WITH:Facility Representative Kecia Loving TIME COMPLETED:
02:00 PM
ALLEGATION(S):
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Staff failed to adhere to food allergy for a Child.
INVESTIGATION FINDINGS:
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On July 27, 2023, at 1:31 p.m., Licensing Program Analyst (LPA) Kendal Zirbes conducted an unannounced follow-up complaint inspection and met with facility representative Kecia Loving. LPA disclosed the purpose of the inspection and was granted entry into the facility. 88 preschool-age children and seven teacher and additional staff were present in the facility during this inspection.

On May 4, 2023, the Department received an allegation alleging that on an unknown date, Child 1 (C1) was provided food to which C1 is allergic. As a result of ingesting the food, C1 received bumps on the body. C1 was under three years of age at the time of this investigation. Over the course of the investigation, LPA reviewed facility records and conducted confidential interviews with staff, parents, and children. Interviews with staff confirmed that in April 2023, during afternoon snack, C1 was observed eating food that C1 is allergic to. Per staff, meals and snacks are served “family style”, meaning the food is placed in the center of the table for the children to serve themselves.
Report continued on page two
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Lady KingTELEPHONE: (310) 568-1824
LICENSING EVALUATOR NAME: Kendal ZirbesTELEPHONE: (661) 202-3491
LICENSING EVALUATOR SIGNATURE:

DATE: 07/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/27/2023
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 5
Control Number 12-CC-20230504091130
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: LA PETITE ACADEMY
FACILITY NUMBER: 364801075
VISIT DATE: 07/27/2023
NARRATIVE
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Report continued from page one

During snack time, C1 was served an alternative food item, however, the food item C1 was allergic to was placed at the table C1 was sitting at, therefore the food item was accessible to C1. C1 obtained access to the food item and ingested the food C1 was allergic to. Interviews confirmed staff were aware of C1's allergies and verbally reminded C1 to not eat the food item. A doctor's note dated 7/28/2022 was reviewed. The doctor's note listed the food items that C1 is allergic to. Facility records documented C1 was offered this food item on 5/18/23.

Based on confidential interviews and record review, the above allegation is valid because the preponderance of the evidence has been met, therefore, the above allegation is found to be substantiated. California Code of Regulations, Title 22, Division 12, Chapter 1, regulation 101223 (a)(2) Personal Rights is being cited on the attached LIC 9099D.
LPA Kendal Zirbes informed facility representative Kecia Loving that this report dated July 27, 2023 documents one Type A citation which shall be posted for 30 consecutive days as there is immediate risk to the health, safety, or personal rights of children in care.

Also, LPA Kendal Zirbes informed the facility representative to provide a copy of this licensing report dated July 27, 2023 that documents any Type A citation 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.

A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100. An exit interview was conducted, and the report was reviewed with facility representative Kecia Loving

SUPERVISOR'S NAME: Lady KingTELEPHONE: (310) 568-1824
LICENSING EVALUATOR NAME: Kendal ZirbesTELEPHONE: (661) 202-3491
LICENSING EVALUATOR SIGNATURE:

DATE: 07/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/27/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 5
Control Number 12-CC-20230504091130
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: LA PETITE ACADEMY
FACILITY NUMBER: 364801075
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/27/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
07/28/2023
Section Cited
CCR
101223(a)(2)
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101223 (a)(2) Personal Rights: The licensee shall ensure that each child is accorded the following personal rights: (2) To be accorded safe, healthful, and comfortable accommodations, furnishings, and equipment to meet his/her needs. This requirement is not met as evidenced by:
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Per facility representative, the food item C1 is allergic to will be removed from the menu while C1 is enrolled. A copy of the menu will be provided to the Department.
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Based on interviews and record review, a safe and healthful environment was not provided when food C1 is allergic to was accessible to C1 resulting in C1 ingesting food to which C1 is allergic, which poses an immediate Health, Safety, and 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: Lady KingTELEPHONE: (310) 568-1824
LICENSING EVALUATOR NAME: Kendal ZirbesTELEPHONE: (661) 202-3491
LICENSING EVALUATOR SIGNATURE:

DATE: 07/27/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/27/2023
LIC9099 (FAS) - (06/04)
Page: 3 of 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
This is an official report of an unannounced visit/investigation of a complaint received in our office on
05/04/2023 and conducted by Evaluator Kendal Zirbes
PUBLIC
COMPLAINT CONTROL NUMBER: 12-CC-20230504091130

FACILITY NAME:LA PETITE ACADEMYFACILITY NUMBER:
364801075
ADMINISTRATOR:TAMMY ESQUIVELFACILITY TYPE:
850
ADDRESS:14040 BEAR VALLEY ROADTELEPHONE:
(760) 241-4748
CITY:VICTORVILLESTATE: CAZIP CODE:
92392
CAPACITY:118CENSUS: 88DATE:
07/27/2023
UNANNOUNCEDTIME BEGAN:
01:31 PM
MET WITH:Facility Representative Kecia Loving TIME COMPLETED:
02:00 PM
ALLEGATION(S):
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9
Staff handle day care children in a rough manner
INVESTIGATION FINDINGS:
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On July 27, 2023, at 1:31 p.m., Licensing Program Analyst (LPA) Kendal Zirbes conducted an unannounced follow-up complaint inspection and met with facility representative Kecia Loving. LPA disclosed the purpose of the inspection and was granted entry into the facility. 88 preschool-age children, seven teachers and additional staff were present in the facility during this inspection.
On May 4, 2023, the Department received an allegation alleging that in February 2023, an unknown staff member grabbed the wrists of an unknown child in the toddler classroom and forcibly sat the child down. Over the course of the investigation, LPA reviewed facility records and conducted confidential interviews with staff and parents. The evidence gathered during the investigation revealed conflicting information. Some interviews reported the teachers did grab the children by the hands or wrists harshly while others denied the teachers grabbed the children by the wrists. According to the management staff, an internal investigation was conducted in February 2023 regarding this allegation.
Report continued on page two
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Lady KingTELEPHONE: (310) 568-1824
LICENSING EVALUATOR NAME: Kendal ZirbesTELEPHONE: (661) 202-3491
LICENSING EVALUATOR SIGNATURE:

DATE: 07/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/27/2023
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 5
Control Number 12-CC-20230504091130
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: LA PETITE ACADEMY
FACILITY NUMBER: 364801075
VISIT DATE: 07/27/2023
NARRATIVE
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Report continued from page one
During the center's internal investigation, video footage of the alleged incident was reviewed by multiple members of the management staff. Based on the Center's internal review, the Center found the allegation to be unfounded. During this investigation, the Department requested to review the video footage of the incident. However, the Center reported the video footage was no longer available.

Based on the information obtained during interviews, it is determined that an unknown staff may or may not have handled day care children in a rough manner. Although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. If additional information is received the investigation may be re-evaluated.

A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100. An exit interview was conducted, and the report was reviewed with facility representative Kecia Loving.
SUPERVISOR'S NAME: Lady KingTELEPHONE: (310) 568-1824
LICENSING EVALUATOR NAME: Kendal ZirbesTELEPHONE: (661) 202-3491
LICENSING EVALUATOR SIGNATURE:

DATE: 07/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/27/2023
LIC9099 (FAS) - (06/04)
Page: 5 of 5