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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198000853
Report Date: 05/17/2023
Date Signed: 05/17/2023 10:49:31 AM

Document Has Been Signed on 05/17/2023 10:49 AM - 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, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:LA PETITE ACADEMY INC.-GRAND AVE.FACILITY NUMBER:
198000853
ADMINISTRATOR:KAMAL GUPTAFACILITY TYPE:
850
ADDRESS:722 SO. GRAND AVE.TELEPHONE:
(909) 860-4009
CITY:DIAMOND BARSTATE: CAZIP CODE:
91765
CAPACITY: 118TOTAL ENROLLED CHILDREN: 118CENSUS: 35DATE:
05/17/2023
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
08:40 AM
MET WITH:Kamal Gupta & Harinda GillTIME COMPLETED:
10:55 AM
NARRATIVE
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Case Management inspection conducted by Licensing Program Analyst (Jennifer Hua). Upon arrival at 8:40am, LPA entered the facility (office) as parent was coming out of front door. No one was in the office. LPA waved to staff (Harinda Gill) in classroom (Pre-k) next to office. LPA introduced self and announced the purpose of the visit. Staff stated that director is on her way. Upon entry of the classroom, LPA observed 1 staff alone supervising 25 children. Staff stated that 2 staff called out today. At 8:43am, Director Kamal Gupta arrived and assisted in the classroom (Pre-K). Director stated that 2 staff called out today, therefore leaving the classroom out of ratio. During the visit, more children arrived. At 8:55am, LPA counted 27 children in the Pre-K room supervised by Director and 1 staff. Director then moved 2 children into the 2s classroom. At 9:56am, 2 additional staff arrived.

Based on observation, deficiency is cited on attached 809D.

Upon receipt of this report documenting a Type A deficiency, the licensee shall do the following:
1. Post the Notice of Site visit and any licensing report documenting a Type “A” deficiency.
2. The report and the Notice of Site visit shall be posted for 30 consecutive days. Failure to maintain posting as required, will result in an immediate $100 civil penalty.
3. A copy of this report shall be provided to the parent/guardian of children currently enrolled by the next business day or immediately upon return. A copy of this report shall also be provided to the parent/guardian of any newly enrolled children for the next 12 months (1 year).
4. The Acknowledgement form (LIC 9224) must be maintained in each child’s file immediately upon receipt from parent. A copy of the parent Acknowledgement of Receipt of Licensing Reports Form was provided during this visit.

Exit interview was conducted with Director, Kamal Gupta, including, but not limited to Provider Rights, Appeal Procedures and Agencies Consultative Role. .
SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Jennifer Hua
LICENSING EVALUATOR SIGNATURE: DATE: 05/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/17/2023
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 05/17/2023 10:49 AM - It Cannot Be Edited


Created By: Jennifer Hua On 05/17/2023 at 09:32 AM
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
, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: LA PETITE ACADEMY INC.-GRAND AVE.
FACILITY NUMBER: 198000853

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/17/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
05/18/2023
Section Cited
CCR
101216.3(a)

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Teacher Child Ratio. There shall be a ratio of one teacher visually observing and supervising no more than 12 children in attendance, except as specified in (b) and (c) below. The requirement is not met as evidenced by: At 8:40am, upon entry of the Pre-k classroom, LPA observed 1 staff was supervising 25 children. This poses an immediate health and
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Per director, 2 staff called out today. Director called 2 staff and 2 additional arrived during visit. Per director, will rearrange staff schedule to have staff come early to ensure compliance.

Deficiency corrected during visit.
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safety risk to 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:Ana Chico
LICENSING EVALUATOR NAME:Jennifer Hua
LICENSING EVALUATOR SIGNATURE:
DATE: 05/17/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/17/2023


LIC809 (FAS) - (06/04)
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