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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376600083
Report Date: 04/12/2023
Date Signed: 04/12/2023 04:16:14 PM

Document Has Been Signed on 04/12/2023 04:16 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, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME:LA PETITE ACADEMYFACILITY NUMBER:
376600083
ADMINISTRATOR:NANISSA MADADIFACILITY TYPE:
850
ADDRESS:12668 SABRE SPRINGS PARKWAYTELEPHONE:
(858) 486-7197
CITY:SAN DIEGOSTATE: CAZIP CODE:
92128
CAPACITY: 123TOTAL ENROLLED CHILDREN: 123CENSUS: 62DATE:
04/12/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
01:50 PM
MET WITH:Nanissa MadadiTIME COMPLETED:
02:30 PM
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On 4/12/23 at 1:50 PM Licensing Program Analysts LPAs Adrian Mangina and Annette Sutherland conducted a case management for the purpose of obtaining information regarding a past employee. LPAs met with Director Nanissa Madadi. During the visit LPAs briefly toured the facility. There were 62 children in care with 7 teachers in 6 classrooms. Proper ratios and supervision were observed

During the visit, LPAs conducted staff interviews, reviewed staff files and obtained staff roster and staff contact information. No deficiencies cited. Exit interview conducted and report was reviewed with the facility representative, Nanissa Madadi. The Licensee was provided a copy of this report. A Notice of Site Visit (LIC9213) was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
SUPERVISORS NAME: Renesha Askew
LICENSING EVALUATOR NAME: Adrian L Mangina
LICENSING EVALUATOR SIGNATURE: DATE: 04/12/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/12/2023
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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