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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 070215126
Report Date: 06/21/2024
Date Signed: 06/21/2024 01:13:04 PM

Document Has Been Signed on 06/21/2024 01:13 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 CC RO, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME:LA PETITE ACADEMY, INC.FACILITY NUMBER:
070215126
ADMINISTRATOR/
DIRECTOR:		HEARN, LORNAFACILITY TYPE:
850
ADDRESS:1350 E. TREGALLASTELEPHONE:
(925) 779-0110
CITY:ANTIOCHSTATE: CAZIP CODE:
94509
CAPACITY: 119TOTAL ENROLLED CHILDREN: 119CENSUS: 9DATE:
06/21/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:00 AM
MET WITH:LORNA HEARNTIME VISIT/
INSPECTION COMPLETED:
01:15 PM
NARRATIVE
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On June 21, 2024 Licensing Program Analyst (LPA) Tasha Alexander met with center director Lorna Hearn to deliver findings to complaint allegations.

During this analyst's investigation, LPA observed one staff member leave the play ground for at least 5 minutes, leaving the co-teacher out of ratio with 14 children. During the investigation it was also revealed that on June 5, 2024 a staff member suffered a medical emergency in the presence of at least 12 day care children. This incident has not been reported to Community Care Licensing as required. LPA is requesting the facility submit the unusual incident within 7 days (6/28/24).

Please see complaint 02-CC-20240610131707 for citation regarding reporting requirements.

Please see attached 809-d for citation regarding ratio requirements

An exit interview was conducted.
A notice of Site visit was Posted.
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.

LIC809 (FAS) - (06/04)
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Document Has Been Signed on 06/21/2024 01:13 PM - It Cannot Be Edited


Created By: Tasha Hackett-Alexander On 06/21/2024 at 12:30 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, 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
101216.3

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101216.3 Teacher-Child Ratio
(a) There shall be a ratio of one teacher visually observing and supervising no more than 12 children in attendance.
THIS REQUIREMENT WAS NOT MET AS EVIDENCED BY: LPA observation. A teacher was observed leaving the play ground for at least 5 minutes, which left the co-teacher out of ratio with 14 children.
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Licensee will conduct a refresher training will all staff on Teacher-Child ratios. Licensee will submit a summary of the training and attendance sheet to community care Licensing by 7/12/24

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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: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


LIC809 (FAS) - (06/04)
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