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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 010216515
Report Date: 01/29/2024
Date Signed: 01/29/2024 03:16:07 PM

Document Has Been Signed on 01/29/2024 03:16 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
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME:LA PETITE ACADEMY - PLEASANTONFACILITY NUMBER:
010216515
ADMINISTRATOR:THERESA GROSSFACILITY TYPE:
830
ADDRESS:5725 VALLEY AVENUETELEPHONE:
(925) 462-7844
CITY:PLEASANTONSTATE: CAZIP CODE:
94566
CAPACITY: 24TOTAL ENROLLED CHILDREN: 24CENSUS: 4DATE:
01/29/2024
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME BEGAN:
09:45 AM
MET WITH:Esther Marical TIME COMPLETED:
03:45 PM
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On January 29, 2024, Licensing Program Analyst (LPA) Lorraine Dacanay Breaux conducted an unannounced Annual Required Inspection and met with Director Esther Mariscal. LPA disclosed the purpose of the inspection and was granted entry into the facility by the Director. There were four (4) children present during this inspection and 8 (eight) additional staff members two (2) teachers for this component . The facility has a school age component #010216516 and Day Care/preschool #10216514. The facility was toured for a health and safety inspection. The hours of operation are 7:00 AM- 06:00 PM, Monday -Friday.

CLASSROOMS: There are adequate play and learning materials available. The floors, furniture, and equipment are age appropriate and in good repair. There is adequate heating/air conditioning, ventilation and lighting. Drinking water is available inside and outside of the center. There is proper individual storage space for each child. The isolation area for sick children is in the office away from the children in care. The center has a wired smoke detectors, carbon monoxide detector, working telephone, pull down fire alarm system, and 6 (six) fully charged 3A40BC fire extinguishers.

BATHROOMS AND TOILETING AREAS: The staff's bathroom is separate from the children's bathroom. All sinks and faucets are in safe and sanitary operating condition. The children are able to reach the sinks and toilets. Supplies are available to the children. Diaper change table is in arm reach of the sinks.

FOOD SERVICE AREAS: Bottles are labeled. There are weekly menus posted at the facility. LPA observed an area were they have a refrigerator this area is clean and free of evidence of rodents. All storage containers for solid waste have tight fitting covers that are in good repair.

OUTDOOR PLAY AREAS: The school has a playground area. All outdoor play structures are in good condition. The play area is fully fenced.


See 809-C
SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Lorraine Dacanay-Breaux
LICENSING EVALUATOR SIGNATURE: DATE: 01/29/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/29/2024
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
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: LA PETITE ACADEMY - PLEASANTON
FACILITY NUMBER: 010216515
VISIT DATE: 01/29/2024
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RECORDS: LPA requested and reviewed files at 1:45 PM. All individuals subject to criminal record review have a clearance or exemption and have been associated to the facility. Children's files and all staff files were reviewed. All staff files have required Health Screening and Employee Rights. All children's files contained Identification & Emergency, Personal Rights, and Medical Consent forms. Sleep log and sleep plan in the children's files. At least one opening/ closing staff member has a current CPR & First Aid Certificate. Mandated Reporter Training was discussed, and certificates were reviewed. The center is following the sign in and out procedure. Per Director the disaster drills are being conducted at least once every 6 months. All required documents are posted in a public accessible area.

HEALTH RELATED SERVICES: NO IMS is being provided in this component. The center is equipped with a fully stocked first aid kit that is available in each classroom.

California Law requires Child Care Centers 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 by phone and LIC 624 must be in the office within 7 days. Roster of the children must be properly maintained and fire/disaster drill every six months must be documented.

LPA discussed the safe sleep regulations with facility representative and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed facility representative of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment. LPA reviewed sleep logs and LIC9227 Sleep Plans for infants.

See 809-C.

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

DATE: 01/29/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/29/2024
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: 010216515
VISIT DATE: 01/29/2024
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Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. 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/childqanda.htm

Lead Testing – Child Care Centers (CCC) CCC COMPLETED TESTING AND NO LEAD EXCEEDANCES: 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. For child care center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1CCP). LPA verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP.

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.

Facility representative was reminded that all adults 18 and over, including employees and volunteers, 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 up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

MyChildCarePlan.org: Director 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.

Director is reminded that Mandated reporter training and CPR is to be completed every 2 years for ALL STAFF.

There are no deficiencies cited today. A notice of site visit was given and must remain posted for 30 days. Appeal Rights provided. Exit interview conducted and report was reviewed with the facility representative, Esther Mariscal.

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

DATE: 01/29/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/29/2024
LIC809 (FAS) - (06/04)
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