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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 444416435
Report Date: 07/27/2022
Date Signed: 07/27/2022 12:19:20 PM

Document Has Been Signed on 07/27/2022 12:19 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:NOLAN, KARENFACILITY TYPE:
850
ADDRESS:3205 SALISBURY DRIVETELEPHONE:
(415) 361-1879
CITY:SANTA CRUZSTATE: CAZIP CODE:
95065
CAPACITY: 38TOTAL ENROLLED CHILDREN: 30CENSUS: 21DATE:
07/27/2022
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
09:01 AM
MET WITH:Lanie ChoiTIME COMPLETED:
12:30 PM
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Licensing Program Analyst (LPA), Cortney Nelson, met with Site Director, Lanie Choi, to follow-up on Plan of Correction (POC) for deficiencies cited during Required- 1 Year annual inspection conducted on 7/25/2022.

During previous inspection, staff member 1 (S1), did not have criminal record clearances prior to working in the facility. Deficiency was cited on 7/25/2022 for S1 and LPA let Site Director know that staff member should not be present at the facility again until she has fingerprint clearances.

Upon arrival to the facility today, LPA observed S1 working with the preschool children without fingerprint clearances. Site Director states that she was going to take S1 to get fingerprinted today. LPA directed Site Director to immediately get S1 fingerprinted and reminded her that S1 should not return to the facility until she has fingerprint clearances. LPA waited at the facility until Site Director returned with completed Livescan form for S1.

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

As a result of today’s inspection, deficiencies were cited, see 809-D.

A NOTICE OF SITE VISIT WAS GIVEN AND MUST REMAIN POSTED FOR 30 DAYS.

LPA informed Site Director, Lanie Choi, that this report dated (7/27/2022) 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 informed the licensee to provide a copy of this licensing report dated (7/27/2022) 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.
SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Cortney Nelson
LICENSING EVALUATOR SIGNATURE: DATE: 07/27/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/27/2022
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 07/27/2022 12:19 PM - It Cannot Be Edited


Created By: Cortney Nelson On 07/27/2022 at 10:48 AM
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: 07/27/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
07/28/2022
Section Cited
CCR
101170(e)

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(e) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1596.871 shall prior to working, residing or volunteering in a licensed facility:

This requirement is not met as evidenced by:
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Site Director will obtain fingerprint clearances for S1 and will not have S1 present at the facility until clearances have been obtained.
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Site Director did not get fingerprint clearances for staff member 1 (S1) after being cited for fingerprint clearances on 7/25/2022 and allowed staff to continue to be present at the facility which poses an immediate threat to the health, safety, and personal rights of children 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:Joel Segura
LICENSING EVALUATOR NAME:Cortney Nelson
LICENSING EVALUATOR SIGNATURE:
DATE: 07/27/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/27/2022


LIC809 (FAS) - (06/04)
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