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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343600872
Report Date: 09/23/2024
Date Signed: 09/23/2024 01:58:13 PM

Document Has Been Signed on 09/23/2024 01:58 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
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:LA PETITE ACADEMY - CITRUS HEIGHTSFACILITY NUMBER:
343600872
ADMINISTRATOR/
DIRECTOR:		JENKINS, JULIEFACILITY TYPE:
840
ADDRESS:8008 OLD AUBURN ROADTELEPHONE:
(916) 723-3094
CITY:CITRUS HEIGHTSSTATE: CAZIP CODE:
95610
CAPACITY: 45TOTAL ENROLLED CHILDREN: 45CENSUS: 8DATE:
09/23/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:10 PM
MET WITH:Robin RivasTIME VISIT/
INSPECTION COMPLETED:
02:15 PM
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On September 23, 2024, Licensing Program Analyst (LPA) Stephanie Piring arrived at the facility for an unannounced case management inspection and met with facility representative, Robin Rivas. The purpose of today's inspection is to follow up on the self reported unusual incident submitted on September 19, 2024.

There was a total census of 8 school age children being supervised by 1 staff LPA conducted observation and interviewed staff present regarding the incident. LPA concluded that no Title 22 regulations were violated.

This report was reviewed with Facility Representative , Robin RIvas. A notice of site visit was provided to be posted for 30 days.
SUPERVISORS NAME: Natalie Dunaway
LICENSING EVALUATOR NAME: Stephanie Piring
LICENSING EVALUATOR SIGNATURE: DATE: 09/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/23/2024
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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