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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 493011077
Report Date: 09/15/2026
Date Signed: 09/15/2026 02:17:12 PM

Document Has Been Signed on 09/15/2026 02:17 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
SANTA ROSA CC RO, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME:LA PETITE ACADEMY, INC.FACILITY NUMBER:
493011077
ADMINISTRATOR/
DIRECTOR:		MELISSA TERHUNEFACILITY TYPE:
860
ADDRESS:9451 BROOKS ROADTELEPHONE:
(707) 838-0549
CITY:WINDSORSTATE: CAZIP CODE:
95492
CAPACITY: 88TOTAL ENROLLED CHILDREN: 50CENSUS: 44DATE:
09/15/2026
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:42 AM
MET WITH:Melissa TerhuneTIME VISIT/
INSPECTION COMPLETED:
10:58 AM
NARRATIVE
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A case management visit was conducted at the facility today by Licensing Program Analyst (LPA) Y. Yang. The LPA was present at the facility for an unrelated matter. During the visit, the LPA met with Center Director Melissa “Mel” Terhune to discuss the facility’s current staffing situation and staff fingerprint clearances.

During a review of the California Department of Social Services’ (CDSS) Guardian background check system, the LPA identified that several staff members working at the facility did not have their fingerprint clearances transferred to the facility’s current license. Further review determined that the Center Director had inadvertently associated the staff members’ fingerprints with the facility’s previous facility number, 493006287. The previous facility number was closed when the center converted to a single-license center on 04/09/2026 and was issued the new facility number, 493011077.

The LPA informed the Center Director of the issue and provided technical assistance. The LPA also assisted the Center Director with transferring the identified staff members to the facility’s current license number. The LPA directed the Center Director to contact Guardian to request user access to the facility’s new license number.

During a tour of the facility, the LPA also observed that the menu posted near the facility’s main entrance was dated August 2025. The Center Director stated that a current menu was not available and acknowledged that no written menu was available for review. The LPA informed the Center Director that menus are required to be in writing and posted at least one week in advance in an area accessible for review by the child’s authorized representative. The LPA further advised the Director that copies of menus as served must be dated and maintained on file for at least 30 days. Menus must also be made available for review by the child’s authorized representative and the Department upon request.

The following violation of the California Code of Regulations, Title 22; Division 12, was observed: see LIC 809D. This report was read and reviewed with the Center Director, Melissa Terhune. Notice of site visit shall be posted for 30 days. Appeal rights provided.

Melchisedeck Augustin
Yang Yang
DATE: 09/15/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/15/2026
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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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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Document Has Been Signed on 09/15/2026 02:17 PM - It Cannot Be Edited


Created By: Yang Yang On 09/15/2026 at 01:47 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
, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405

FACILITY NAME: LA PETITE ACADEMY, INC.
FACILITY NUMBER: 493011077

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/15/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/30/2026
Section Cited
CCR
101227(a)(6)

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Menus shall be in writing and shall be posted at least one week in advance in an area accessible for review by the child's authorized representative. Copies of the menus as served shall be dated and kept on file for at least 30 days. Menus shall be made available for review by the child's authorized representative and the Department upon request. This requirement was not met as evidenced by:

Based on the LPA's observation on 09/15/2026 and interview with the Center Director, the facility did not ensure that a current written menu was posted and available for review. During a tour of the facility, the LPA observed that the menu posted near the facility's main entrance was dated August 2025. When asked to provide the current menu, the Center Director stated that a current menu was not available and acknowledged that no current written menu was available for review. This poses a potential risk to the health and safety of children in care
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The Center Director will ensure that a current written menu is posted in the designated area and remains available for review as required.

The Center Director will review the menu requirements with staff responsible for meal planning and posting menus to ensure ongoing compliance. Copies of menus as served will be dated and maintained on file for at least 30 days and will be made available for review by the child’s authorized representative and the Department upon request.

The Center Director will submit a copy of the current written menu for the month of October 2026 to the LPA by 09/30/2026 as verification of correction.
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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.
Melchisedeck Augustin
NAME OF LICENSING PROGRAM MANAGER:
Yang Yang
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 09/15/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/15/2026


LIC809 (FAS) - (06/04)
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