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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 070215131
Report Date: 11/01/2023
Date Signed: 11/01/2023 03:34:51 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 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
10/23/2023 and conducted by Evaluator Indira Loza
PUBLIC
COMPLAINT CONTROL NUMBER: 02-CC-20231023101522
FACILITY NAME:LA PETITE ACADEMY, INC.FACILITY NUMBER:
070215131
ADMINISTRATOR:DAVIS, GRETAFACILITY TYPE:
850
ADDRESS:3891 LAKESIDE DRIVETELEPHONE:
(510) 222-3070
CITY:RICHMONDSTATE: CAZIP CODE:
94806
CAPACITY:84CENSUS: DATE:
11/01/2023
UNANNOUNCEDTIME BEGAN:
12:26 PM
MET WITH:Greta DavisTIME COMPLETED:
03:41 PM
ALLEGATION(S):
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Personal Rights - Facility leaves child in a high chair for extended periods of time
INVESTIGATION FINDINGS:
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On November 1, 2023 at 12:26pm Licensing Program Analyst (LPA) Indira Loza met with Director Greta Davis for the purpose of investigating a complaint. Present during today's inspection were 34 preschoolers and 5 staff. During the course of the investigation interviews and record reviews were conducted.

The above allegation states that staff had a child restrained in a feeding chair for an extended period of time. Based on interviews and record reviews it has been determined that staff did place a two year old child in a low feeding chair in order to keep the child contained in one area. Based on the interviews and information obtained throughout the investigation, the preponderance of evidence standard has been met and and the above allegation is being Substantiated. Based on California Code of Regulations, Title 22, Division 12 is being cited a on 9099-D page, the Citation being issued is a Type A citation. See LIC 9099-D for citation.

A copy of the report and an Acknowledgment of Receipt of Licensing Reports (LIC9224) must be provided to all parents of currently enrolled children, all parents are to be given the report the next day they see the
*************************************See LIC9099-C for Report continuance***************************
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Indira Loza
LICENSING EVALUATOR SIGNATURE:

DATE: 11/01/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/01/2023
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 3
Control Number 02-CC-20231023101522
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		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: 070215131
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/01/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
11/02/2023
Section Cited
CCR
101223(a)(1)
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(a) The licensee shall ensure that each child is accorded the following personal rights: (1) To be accorded dignity in his/her personal relationships with staff and other persons. This requirement was not met as evidenced by:
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The Director shall develop a written plan of action to ensure there are no further incidents. The Director shall submit the written plan to CCL by 11/2/23.
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Based on interviews and record review it has been determined that a child was placed in a low feeding chair on one occasion to keep them contained in one area which is an immediate risk to the Health, Safety, and Personal Rights to children in care.
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• Failure to correct will result in a $100 per day civil penalty until corrected. Repeat violations are $250 per violation and $100 per day until corrected.
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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: Mayla Mendoza
LICENSING EVALUATOR NAME: Indira Loza
LICENSING EVALUATOR SIGNATURE:

DATE: 11/01/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/01/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 02-CC-20231023101522
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		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: 070215131
VISIT DATE: 11/01/2023
NARRATIVE
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child. The report must be given to parents of children enrolled 12 months after today's date. The LIC9224 must be maintained in the children's files for 3 years.

Exit interview conducted. Appeal Rights and Report reviewed and provided to Director Greta Davis. Notice of Site Visit must remain posted ofr 30 days.
SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Indira Loza
LICENSING EVALUATOR SIGNATURE:

DATE: 11/01/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/01/2023
LIC9099 (FAS) - (06/04)
Page: 3 of 3