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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 444416435
Report Date: 05/02/2024
Date Signed: 05/02/2024 06:05:53 PM

Document Has Been Signed on 05/02/2024 06:05 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, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME:L'ACADEMY PRESCHOOL SANTA CRUZFACILITY NUMBER:
444416435
ADMINISTRATOR/
DIRECTOR:		LANIE CHOIFACILITY TYPE:
850
ADDRESS:3205 SALISBURY DRIVETELEPHONE:
(831) 479-7790
CITY:SANTA CRUZSTATE: CAZIP CODE:
95065
CAPACITY: 38TOTAL ENROLLED CHILDREN: 23CENSUS: 18DATE:
05/02/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:05 AM
MET WITH:Lanie ChoiTIME VISIT/
INSPECTION COMPLETED:
04:41 PM
NARRATIVE
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Licensing Program Analyst (LPA), Cortney Nelson, met with Site Director, Lanie Choi, for an unannounced Annual/Random Inspection. LPA was granted access to the facility by staff members present and toured both indoors and outdoors during the inspection. Lanie arrived to the facility at approximately 10:00AM. Upon arrival, there were eighteen preschool-age children and three staff (two teachers/one assistant) present, which is compliant with the facility license capacity and ratio requirements. LPA observed all required postings near the entrance to the facility and the hours of operation are Monday – Friday, 7:30AM-5:30PM.

LPA reviewed sign-in/out, facility roster (LIC9040), and fire/disaster drill log during today’s inspection. Sign-in/out was observed to be completed digitally using 1core. The last fire/disaster drill was conducted on 4/26/2024, which is compliant with the six-month requirement for facilities. LPA observed two fully charged 2A10BC fire extinguishers (last serviced: 8/2023), built in fire detection system and functioning carbon monoxide detector. There are children in care who require Incidental Medical Services (IMS) for EpiPens and do administer medication at this time. LPA observed that medication is properly stored out of reach of children with most proper documentation. LPA reminded that physicians paperwork shall be obtained for prescription medication and IMS medication. There are no weapons or firearms on the premises.

This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and
administrative records.
For IMS information see PIN 22-02-CCP. 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/.
SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Cortney Nelson
LICENSING EVALUATOR SIGNATURE: DATE: 05/02/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/02/2024
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
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: L'ACADEMY PRESCHOOL SANTA CRUZ
FACILITY NUMBER: 444416435
VISIT DATE: 05/02/2024
NARRATIVE
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Indoor areas of the facility were inspected by the LPA today and observed to be clean, orderly, and safe for the day care children. LPA observed sufficient age-appropriate materials, toys, and play equipment in the facility. During today's inspection, LPA observed children engaged in playing with small activities, napping, and playing outside. The floors were clean and free of tripping hazards. Drinking water is readily available for children via water dispensers and water bottles from home labeled with the children’s names. Staff and children’s bathrooms are clean, sanitary, and operable. There is a separate staff bathroom, not utilized by the children, which an isolated child can use if necessary. There is a working telephone in the facility.

The outdoor area of the facility was inspected and observed to be fenced in. There is a playground, riding bikes, large lego blocks, and other toys for the children to play with. LPA observed play equipment was in good condition, age-appropriate, and has sufficient resilient materials to absorb falls. No outdoor bodies of water were observed during today’s inspection. Shaded rest area is provided by building overhang.

The facility offers a full day program and provides midmorning snack, midafternoon snack, and lunch to the children in care. Menu is in writing and posted at least one week in advance, accessible to authorized representatives. Lanie states that the menu is emailed weekly to parents. The kitchen and storage area is clean and free of litter and rubbish. LPA advised proper storage for food that has been served to children as containers are not adequately sealed or labeled for day the food was served. LPA advised cleaning out the fridge and advising staff of proper food storage for opened containers, including a sealed storage container, date of use, and for longer lasting food, indicating expiration date.

Five (5) children’s files were reviewed and all required documents were present. Four (4) staff files were reviewed and most required documents were present. LPA reminded to retain proof of immunization to measles, pertussis, and influenza, or a declination to influenza. Lanie has current CPR/First-Aid that expires 6/2025 and her Mandated Reporter training has expired. LPA reminded that the Mandated Reporter Training must be renewed by all staff every 2 years and completed by new staff within 90 days of hire.
SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Cortney Nelson
LICENSING EVALUATOR SIGNATURE:

DATE: 05/02/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/02/2024
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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, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: L'ACADEMY PRESCHOOL SANTA CRUZ
FACILITY NUMBER: 444416435
VISIT DATE: 05/02/2024
NARRATIVE
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Licensee 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.

The Site Director understands that she shall be on the premises during the hours the center is in operation and that children at the center shall be visually supervised at all times. LPA reminded that there shall be at least one person with valid CPR and First-Aid certifications on site at all times or present during off site activities, such as field trips.

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. The facility completed water lead testing on 11/1/2022 and no action level exceedances were found.

Exit interview conducted and report was reviewed with the Site Director, Lanie Choi.

As a result of today’s inspection, deficiencies were cited, see LIC809-D.

A NOTICE OF SITE VISIT WAS GIVEN AND MUST REMAIN POSTED FOR 30 DAYS.
SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Cortney Nelson
LICENSING EVALUATOR SIGNATURE:

DATE: 05/02/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/02/2024
LIC809 (FAS) - (06/04)
Page: 3 of 5
Document Has Been Signed on 05/02/2024 06:05 PM - It Cannot Be Edited


Created By: Cortney Nelson On 05/02/2024 at 02:45 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
, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: L'ACADEMY PRESCHOOL SANTA CRUZ
FACILITY NUMBER: 444416435

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/02/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
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 as two out of four staff members need to complete Mandated Reporter training, which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 05/17/2024
Plan of Correction
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The Licensee shall submit proof of completed Mandated Reporter training for Child Care Providers (AB1207) and submit certificates to the Department by 5/17/2024. (www.mandatedreporterca.com) LPA advised that new hires have 90 days to complete the training.
Type B
Section Cited
HSC
1596.7995(a)(1)
General Provisions and Definitions
(1) Commencing September 1, 2016, a person shall not be employed or volunteer at a day care center if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year.

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 as one staff member was missing proof of immunization to measles, which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 05/31/2024
Plan of Correction
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The Site Director shall submit proof of measles for one staff member to the Department by 5/31/2024. LPA advised that proof of immunization shall be obtained for new staff within 30 days of hire. A blood panel may also be completed to establish immunity.
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:Joel Segura
LICENSING EVALUATOR NAME:Cortney Nelson
LICENSING EVALUATOR SIGNATURE:
DATE: 05/02/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/02/2024


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Document Has Been Signed on 05/02/2024 06:05 PM - It Cannot Be Edited


Created By: Cortney Nelson On 05/02/2024 at 02:45 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
, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: L'ACADEMY PRESCHOOL SANTA CRUZ
FACILITY NUMBER: 444416435

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/02/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101226(e)(3)(B)
Health-Related Services
(3) Prescription medications may be administered if all of the following conditions are met: (B) For each prescription medication, the licensee shall obtain, in writing, approval and instructions from the child's authorized representative for the administration of the medication to the child.

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 as no paperwork was completed for the child's EpiPen, including parent consent and physicans note, which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 05/17/2024
Plan of Correction
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Physicians information obtained during todays inspection, obtain parental consent (LIC9221) if not present with EpiPen medication.
Type B
Section Cited
CCR
101227(a)(1)
Food Service
(1) All food shall be safe and of the quality and in the quantity necessary to meet the needs of the children. Each meal shall include, at a minimum, the amount of food components as specified by Title 7, Code of Federal Regulations, Part 226.20, (Revised January 1, 1990) Requirements for Meals, for the age group served. All food shall be selected, stored, prepared and served in a safe and healthful manner.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation and interview, the licensee did not comply with the section cited above as opened food containers were not properly sealed in the freezer and pantry, and the fridge needs to be cleaned, which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 05/17/2024
Plan of Correction
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The Site Director shall review proper storage of opened food containers with staff, including moving to a sealed container, such as a ziplock, adding the date the food was served, and expiration date if long lasting food. LPA additionally advised that fridge needs to be cleaned out as it was observed to be dirty inside. Photos of proper food storage and cleaned fridge to be submitted by 5/17/2024.
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:Joel Segura
LICENSING EVALUATOR NAME:Cortney Nelson
LICENSING EVALUATOR SIGNATURE:
DATE: 05/02/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/02/2024


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