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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 010216514
Report Date: 02/12/2025
Date Signed: 02/12/2025 01:15:59 PM

Document Has Been Signed on 02/12/2025 01:15 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
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME:LA PETITE ACADEMY - PLEASANTONFACILITY NUMBER:
010216514
ADMINISTRATOR/
DIRECTOR:		ESTHER MARISCALFACILITY TYPE:
850
ADDRESS:5725 VALLEY AVENUETELEPHONE:
(925) 462-7844
CITY:PLEASANTONSTATE: CAZIP CODE:
94566
CAPACITY: 89TOTAL ENROLLED CHILDREN: 89CENSUS: 0DATE:
02/12/2025
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:30 AM
MET WITH:Esther MariscalTIME VISIT/
INSPECTION COMPLETED:
01:40 PM
NARRATIVE
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On February 12, 2025, Licensing Program Analyst (LPA) Lorraine Dacanay Breaux conducted an Unannounced Annual Required Inspection. LPA met with Director, Esther Mariscal, also present at the time of the inspection were 3 additional staff & 21 preschool age children. LPA provided facility representative the Entrance Checklist (LIC 125). The facility was toured to conduct a Health and Safety inspection. The facility currently operates 7:00 am - 6:00 pm, Monday - Friday in 2 classrooms. The facility has a school age component #010216516 and Infant component #10216515.

Classrooms: All classrooms were inspected for age-appropriate furnishings, equipment, & adequate storage for children’s belongings. LPA observed the cleanliness of floors & surfaces, the presence of a fully functional carbon monoxide detector testing and functioning located in the kitchen, smoke detector/fire alarms, and a fully charged 3A40BC fire extinguisher that is accessible throughout the facility. The center is equipped with a fully stocked first-aid kit and available in the classrooms. LPA inspected the area with napping equipment facility uses cots and/or mats.

Food Service Areas: All center provided food items are properly labeled & stored separately from cleaning supplies. Food prep area is clean, adequately equipped, & free from hazardous materials. Lunch and snack menu is posted one week in advance, available for review, & dated. Solid waste bins are equipped with tight fitting lid.

Bathrooms: Facility has separate staff and child designated bathrooms. Toilets and faucets are in safe and sanitary operating condition. The children are able to reach the sinks, toilets, and supplies. Diaper changing table is within arms reach of the sinks.

Outdoor Play Area: The playground outside is fenced and all equipment and surfaces are free from hazards. There are no bodies of water, or free-standing water accessible to children. There are age-appropriate outdoor toys and materials for the children. The play structure is securely installed into the ground. The ground surrounding the play structure has bark and padding. LPA did not observe any swimming pools and/or bodies of water, director confirmed that are no swimming pools/bodies of water at the facility.

Page 1 of 3 ***Continued on LIC 809-C***

SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Lorraine Dacanay-Breaux
LICENSING EVALUATOR SIGNATURE: DATE: 02/12/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/12/2025
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
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: LA PETITE ACADEMY - PLEASANTON
FACILITY NUMBER: 010216514
VISIT DATE: 02/12/2025
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Incidental Medical Services (IMS): Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. When any IMS is provided, an updated Plan of Operation that includes IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at http://www.ada.gov/resources/child-care-centers/.

Per Director there are no children that require medication during today's visit.

Unusual Incident/Student Injury Report: Effective August 1, 2003 California Law requires Child Care Licensees to report unusual incidents or injuries to children in care to child’s parents and to the Department of Social Services using the Unusual Incident/Injury Form (LIC 624). Incidents must be reported within 24 hours to the regional office by phone and the written report, LIC 624, within 7 business days.

MyChildCarePlan.org: Facility representative was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

One (1) deficiency type B and two (2) advisory note issued today:

· Type B Violation: Director was unable to provide a copies of the current


LIC 9040 Children Care Roster for all components.

· Advisory Note (TV): One staff member's Mandated Reporter Certificate needs to be renewed within 5 consecutive days. (general and child care providers)


  • Advisory Note (TV): LIC 9052 Employee Rights" and LIC 9108 was not in the employee's file.

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. Appeal rights were given and reviewed. Exit interview conducted and report was reviewed with the director, Esther Mariscal and Assistant Director Christina Zarate.

Page 3 of 3 ***End of Report***

SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Lorraine Dacanay-Breaux
LICENSING EVALUATOR SIGNATURE:

DATE: 02/12/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/12/2025
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
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: LA PETITE ACADEMY - PLEASANTON
FACILITY NUMBER: 010216514
VISIT DATE: 02/12/2025
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Records: At 10:30 AM LPA requested and reviewed 6 children files and 5 staff records. All individuals subject to criminal record review have a clearance and have been associated to the facility. LPA reviewed the facility roster and obtained a copy. At least one opening/closing staff member has a current Pediatric CPR/First-Aid Certification. Mandated Reporter certificates were reviewed. Director was reminded of their responsibility to renew CPR/First Aid and Mandated Reporter certificates every two years. The center is in compliance with sign in and out procedure using an electronic app. Emergency Drills are recorded and performed at least every six months last one was December 5, 2025 . Per director, there are no firearms on the premises. LPA reminded director that online CPR/First Aide is not accepted by CCLD. LPA reminded director that LIC 9040 must be maintained and kept for 3 years.

CCLD Inspection Process: To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.

Criminal Record Clearance: Facility representative 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.

Lead Testing: 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. LPA verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP.

LPA reminded director to have the Lead Testing results posted at the entrance for public review and must remain posted until the next required testing.

Page 2 of 3 ***Continued on LIC 809C***

SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Lorraine Dacanay-Breaux
LICENSING EVALUATOR SIGNATURE:

DATE: 02/12/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/12/2025
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 02/12/2025 01:15 PM - It Cannot Be Edited


Created By: Lorraine Dacanay-Breaux On 02/12/2025 at 12:29 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
, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: LA PETITE ACADEMY - PLEASANTON
FACILITY NUMBER: 010216514

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/12/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1596.841


This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the director did not comply with the section cited above in not being able to provide copies of the Child Care Roster (LIC9040) to the LPA which poses/posed a potential health, safety or personal rights risk to persons in care. During record review, director was unable to provide LPA with the children's roster for the children at the facility.
POC Due Date: 02/18/2025
Plan of Correction
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Director will ensure to submit an completed for the Facility Roster (LIC 9040) to CCLD by 2/18/2025. All sections on this form must be completely filled out (EX: child's full name/parents complete name, physician and physician's phone numbers, date enrolled and left. All areas and fields of this form must be filled out accurately and completely and must be maintained at the facility for 3 years. Director will email a copies for all componets to the LPA at Lorraine.Dacanay-Breaux@dss.ca.gov

Section Cited
Deficient Practice Statement
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POC Due Date:
Plan 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.
SUPERVISOR'S NAME:Chandra Charles
LICENSING EVALUATOR NAME:Lorraine Dacanay-Breaux
LICENSING EVALUATOR SIGNATURE:
DATE: 02/12/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/12/2025


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