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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 070215126
Report Date: 10/03/2022
Date Signed: 10/03/2022 03:43:12 PM

Document Has Been Signed on 10/03/2022 03:43 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, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME:LA PETITE ACADEMY, INC.FACILITY NUMBER:
070215126
ADMINISTRATOR:HEARN, LORNAFACILITY TYPE:
850
ADDRESS:1350 E. TREGALLASTELEPHONE:
(925) 779-0110
CITY:ANTIOCHSTATE: CAZIP CODE:
94509
CAPACITY: 119TOTAL ENROLLED CHILDREN: 119CENSUS: 20DATE:
10/03/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Lorna HearnTIME COMPLETED:
04:00 PM
NARRATIVE
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On 10/03/2022 at 1:00 PM, Licensing Program Analyst (LPA) Christina Watts conducted an unannounced Case Management inspection for the Lead Testing results at La Petite Academy. LPA met with Director, Lorna Hearn and guided analyst on a tour of the facility. During inspection of facility, there were 20 children in care between three classrooms and 3 staff..

There was an indicator that there was three outlet that exceeded the Action Level exposure. Facility has replaced two out of three outlets while the third outlet has been made inoperable for children. Facility has planned to retest two outlets. LPA received a Plan of Correction and facility has submitted the documentation for the post-testing requirements.

The following deficiency is (See LIC 809-D.) cited from the California Code of Regulations, Title 22. A notice of site visit was given and must remain posted for 30 consecutive days. Exit interview conducted and report was reviewed with the Director Lorna Hearn.

SUPERVISORS NAME: Sherelle Johnson
LICENSING EVALUATOR NAME: Christina Watts
LICENSING EVALUATOR SIGNATURE: DATE: 10/03/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/03/2022
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 10/03/2022 03:43 PM - It Cannot Be Edited


Created By: Christina Watts On 10/03/2022 at 03:14 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, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: LA PETITE ACADEMY, INC.
FACILITY NUMBER: 070215126

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/03/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
11/03/2022
Section Cited
CCR
101238(a)

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101238 Buildings and Grounds (a)The child care center shall be clean, safe, sanitary and in good repair at all times to ensure the safety and well-being of children, employees and visitors. This requirement is not met as evidenced by:
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Faciilty has replaced the faucet and is scheduled to re-test. Facility provided all documentation for lead test.
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Based on Lead Testing Samples the facility has three water faucet with lead exposure. This is an potential risk to Health and Safety or Personal Rights risk to persons in care.
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By 11/3/2022 Director agreed to submit a written plan to ensure children are provided alternative safe drinking water.

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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:Sherelle Johnson
LICENSING EVALUATOR NAME:Christina Watts
LICENSING EVALUATOR SIGNATURE:
DATE: 10/03/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/03/2022


LIC809 (FAS) - (06/04)
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