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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 010216516
Report Date: 02/05/2024
Date Signed: 02/05/2024 05:21:13 PM

Document Has Been Signed on 02/05/2024 05:21 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:
010216516
ADMINISTRATOR:THERESA GROSSFACILITY TYPE:
840
ADDRESS:5725 VALLEY AVENUETELEPHONE:
(925) 462-7844
CITY:PLEASANTONSTATE: CAZIP CODE:
94566
CAPACITY: 30TOTAL ENROLLED CHILDREN: 30CENSUS: 17DATE:
02/05/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
02:45 PM
MET WITH:Esther MaricalTIME COMPLETED:
05:30 PM
NARRATIVE
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On February 5, 2024, Licensing Program Analyst (LPA)Lorraine Dacanay Breaux arrived at the Facility unannounced for an required annual inspection for pre-school component #10216514. Also present during the inspection was one (1) staff for this school age component and one (1) ABA, and 17 school age children in care. LPA found a deficiency unrelated to the annual being conducted under Preschool component #10216514 resulting in this case management report.

At around 3:00PM, LPA Dacanay Breaux observed a teacher supervising 17 children in the playground. The director did step into the classroom to meet the compliance. LPA requested for the staff file and after reviewing LPA discovered the staff is a "teacher's aide". Due to the staff not being a fully qualified teacher, staff is unable to be left alone with children.

LPA did a consolation with the director and provided copies of the following Title 22 Regulations: 10126.2 (Teacher Aide Qualifications and Duties) and 101516.5 (Teacher Child Ratio)

Due to the school being out of ratio, a Type B Violation is being cited today.

Please see the attached deficiency page LIC 809-D.

A notice of site visit was given and must remain posted for 30 days.

Appeals rights were given and reviewed

Exit interview was conducted and report was reviewed with the Director , Esther Marical.
SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Lorraine Dacanay-Breaux
LICENSING EVALUATOR SIGNATURE: DATE: 02/05/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/05/2024
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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Document Has Been Signed on 02/05/2024 05:21 PM - It Cannot Be Edited


Created By: Lorraine Dacanay-Breaux On 02/05/2024 at 04:30 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: 010216516

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/05/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/09/2024
Section Cited
CCR
101516.5

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101516.5 Teacher-Child Ratio
(a) There shall be a staffing ratio of one teaher and one aide present to every 28 children in attendance.

This requirement was not met as evidenced by:
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The director and staff shall watch the "Teacher-Child Ratio" training video on the CCLD website and develop a written plan to ensure the ratio is always maintained. The facility shall submit the action plan in writing by 02/09/2024.
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Based on observations, interviews, and record reviews, the licensee did not comply with the section cited above. LPA observed that S1 was supervising 17 children in the playground, and per S1 was left alone on multiple occasions which poses a potential risk to the health, safety, or 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:Chandra Charles
LICENSING EVALUATOR NAME:Lorraine Dacanay-Breaux
LICENSING EVALUATOR SIGNATURE:
DATE: 02/05/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/05/2024


LIC809 (FAS) - (06/04)
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