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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 070215126
Report Date: 06/21/2024
Date Signed: 06/21/2024 01:09:20 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND CC RO, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
This is an official report of an unannounced visit/investigation of a complaint received in our office on
06/10/2024 and conducted by Evaluator Tasha Hackett-Alexander
COMPLAINT CONTROL NUMBER: 02-CC-20240610131707
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:119CENSUS: 9DATE:
06/21/2024
UNANNOUNCEDTIME BEGAN:
08:12 AM
MET WITH:LORNA HEARNTIME COMPLETED:
01:15 PM
ALLEGATION(S):
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LACK OF SUPERVISION- Staff was not supervising the children on the playground and a child fell off a play structure
INVESTIGATION FINDINGS:
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On June 21, 2024 Licensing Program Analyst (LPA) Tasha Alexander met with center director Lorna Hearn to deliver the findings to the above complaint allegation.

Upon arrival there are 9 preschool age children present along with 2 preschool staff. On this analyst's last inspection, a tour of the play ground was conducted, activities were observed, records were reviewed and staff interviews were conducted. Today pictures were taken of the play ground slide. Further investigation has been conducted and it was found that although there were 2 staff members on the play ground at the time of the incident, proper visual supervision was not practiced.

Based on LPAs observations and interviews which were conducted and record reviews, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED.

California Code of Regulations, Title 22, Division 12 & Chapter 1, are being cited on the attached LIC. 9099D.
A Notice Of Site visit was posted
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Monica Mathur
LICENSING EVALUATOR NAME: Tasha Hackett-Alexander
LICENSING EVALUATOR SIGNATURE:

DATE: 06/21/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/21/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 6
Control Number 02-CC-20240610131707
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND CC RO, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: LA PETITE ACADEMY, INC.
FACILITY NUMBER: 070215126
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/21/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/12/2024
Section Cited
CCR
101229(a)
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101229 Responsibility for Providing Care and Supervision
(a) The licensee shall provide care and supervision as necessary to meet the children's needs.
THIS REQUIREMENT WAS NOT MET
AS EVIDENCED BY: interviews, observations ,
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The center director has since instructed staff to stand in close proximity while providing visual supervision when child are playing on the open slide. Licensee will also conduct an all staff training on playground supervision and submit a summary of the training and a sign in sheet of all staff that attended by 7/12/24.
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and a review of records which revealed staff was not properly supervising children on the play ground and a child fell from the slide.
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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.
SUPERVISORS NAME: Monica Mathur
LICENSING EVALUATOR NAME: Tasha Hackett-Alexander
LICENSING EVALUATOR SIGNATURE:

DATE: 06/21/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/21/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 6
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND CC RO, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
This is an official report of an unannounced visit/investigation of a complaint received in our office on
06/10/2024 and conducted by Evaluator Tasha Hackett-Alexander
COMPLAINT CONTROL NUMBER: 02-CC-20240610131707

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:119CENSUS: 9DATE:
06/21/2024
UNANNOUNCEDTIME BEGAN:
08:12 AM
MET WITH:LORNA HEARNTIME COMPLETED:
01:15 PM
ALLEGATION(S):
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9
NEGLECT/LACK OF SUPERVISION- Child left unattended on the playground for 3 minutes
INVESTIGATION FINDINGS:
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On June 21, 2024 Licensing Program Analyst (LPA) Tasha Alexander met with center director Lorna Hearn to deliver the findings to the above complaint allegation.

Upon arrival there are 9 preschool age children present along with 2 preschool staff. On this analyst's last inspection, a tour of the play ground was conducted, records were reviewed and staff interviews were conducted.

Based on LPAs observations and interviews which were conducted and record reviews, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED.
California Code of Regulations, Title 22, Division 12 & Chapter 1, are being cited on the attached LIC. 9099D.

The LIC 9224 Acknowledgement of Receipt of Licensing Report form has been given and explained. A copy of this report must be given to each day care child's parent/guardian by the next business day and a signed copy of the LIC 9224 must be put into their child's file. A copy must also be given to any newly enrolled child's parent for up to one year. This report must be posted for 30 days.

Appeal Rights given/A Notice of Site visit was posted
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Monica Mathur
LICENSING EVALUATOR NAME: Tasha Hackett-Alexander
LICENSING EVALUATOR SIGNATURE:

DATE: 06/21/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/21/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 3 of 6
Control Number 02-CC-20240610131707
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND CC RO, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: LA PETITE ACADEMY, INC.
FACILITY NUMBER: 070215126
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/21/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
07/12/2024
Section Cited
CCR
101229(a)(1)
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101229 Responsibility for Providing Care and Supervision
(a) The licensee shall provide care and supervision as necessary to meet the children's needs.
(1) No child(ren) shall be left without the supervision of a teacher at any time, except as specified in Sections 101216.2(e)(1) and 101230(c)(1). Supervision shall include visual observation.
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Licensee will ensure the face to name sheet and roll call practices are followed to prevent future incidents. Licensee will be conducting an all staff training on play ground supervision and will encorporate trainings on class room supervision, and face to name sheet and roll practices. proof of trainings will be submitted to community care licensing by 7/12/24.
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THIS REQUIREMENT WAS NOT MET AS EVIDENCED BY INTERVIEWS WHICH REVEALED A CHILD WAS LEFT UNATTENDED ON THE PLAY GROUND FOR A PERIOD OF TIME.
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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.
SUPERVISORS NAME: Monica Mathur
LICENSING EVALUATOR NAME: Tasha Hackett-Alexander
LICENSING EVALUATOR SIGNATURE:

DATE: 06/21/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/21/2024
LIC9099 (FAS) - (06/04)
Page: 4 of 6
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND CC RO, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
This is an official report of an unannounced visit/investigation of a complaint received in our office on
06/10/2024 and conducted by Evaluator Tasha Hackett-Alexander
COMPLAINT CONTROL NUMBER: 02-CC-20240610131707

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:119CENSUS: 9DATE:
06/21/2024
UNANNOUNCEDTIME BEGAN:
08:12 AM
MET WITH:LORNA HEARNTIME COMPLETED:
01:15 PM
ALLEGATION(S):
1
2
3
4
5
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7
8
9
REPORTING REQUREMENTS- Child left unattended on the playground was not reported
INVESTIGATION FINDINGS:
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On June 21, 2024 Licensing Program Analyst (LPA) Tasha Alexander met with center director Lorna Hearn to deliver the findings to the above complaint allegation.

Upon arrival there are 9 preschool age children present along with 2 preschool staff. On this analyst's last inspection, a tour of the play ground was conducted, staff interviews were conducted and records were reviewed. It has confirmed that the incident occrurred, however, it was not reported to Community Care Licensing as required.

Based on LPAs observations and interviews which were conducted and record reviews, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED.

California Code of Regulations, Title 22, Division 12 & Chapter 1, are being cited on the attached LIC. 9099D.

A Notice of Site visit was posted
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Monica Mathur
LICENSING EVALUATOR NAME: Tasha Hackett-Alexander
LICENSING EVALUATOR SIGNATURE:

DATE: 06/21/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/21/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 5 of 6
Control Number 02-CC-20240610131707
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND CC RO, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: LA PETITE ACADEMY, INC.
FACILITY NUMBER: 070215126
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/21/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
06/28/2024
Section Cited
CCR
101212(d)(1)(c)
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101212 Reporting Requirements
(d) Upon the occurrence, during the operation of the child care center of any of the events specified in (d)(1) below, a report shall be made to the Department by telephone or fax within the Department's next working day and during its normal business hours. In addition, a written report containing the information specified in (d)(2) below shall be submitted to the Department within seven days following the occurrence of such event.
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Licensee will ensure that all future unusual incidents are reported to Community Care Licensing within 24 hours of the incident happening and submit a written unusual incident report within 7 days of the incident. Licensee will also submit an unusual incident regarding this incident to Community Care Licensing by 6/28/24.
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(1) Events reported shall include the following:
(C) Any unusual incident or child absence that threatens the physical or emotional health or safety of any child.
THIS REQUIREMENT WAS NOT MET AS EVIDENCED BY: A interviews and record reviews which revealed a child was left unattended on the play ground for a period of time and the incident was not reported to Community Care Licenisng as required.
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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.
SUPERVISORS NAME: Monica Mathur
LICENSING EVALUATOR NAME: Tasha Hackett-Alexander
LICENSING EVALUATOR SIGNATURE:

DATE: 06/21/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/21/2024
LIC9099 (FAS) - (06/04)
Page: 6 of 6