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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343600873
Report Date: 03/26/2024
Date Signed: 03/26/2024 11:34:10 AM

Document Has Been Signed on 03/26/2024 11:34 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
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:LA PETITE ACADEMY - CITRUS HEIGHTSFACILITY NUMBER:
343600873
ADMINISTRATOR:JENKINS, JULIEFACILITY TYPE:
850
ADDRESS:8008 OLD AUBURN ROADTELEPHONE:
(916) 723-3094
CITY:CITRUS HEIGHTSSTATE: CAZIP CODE:
95610
CAPACITY: 77TOTAL ENROLLED CHILDREN: 77CENSUS: 32DATE:
03/26/2024
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Robin RivasTIME COMPLETED:
11:45 AM
NARRATIVE
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On March 26, 2024, Licensing Program Analyst (LPA) Kyrsten Williams met with facility representatives, director Robin Rivas and district manager Teresa Addison, for the purpose of a Plan of Correction (POC) inspection. On November 6, 2023, one type B citation was issued. Plan of Correction (POC) were originally due 12/13/2023. Upon arrival, LPA observed 32 preschool children being supervised by 5 staff members. All individuals subject to criminal background review have obtained a criminal record clearance.

LPA completed a record review of staff files. LPA observed staff files include the following required documents: Health Screening (LIC503), Statement Acknowledging Requirement to Report Child Abuse (LIC9108), Employee Rights (LIC9052), Education Transcripts, and most files include immunization record. LPA will clear deficiency CCR 101217(d) that was cited on 11/06/2023. LPA did not observe a current Mandated Reporter Training certificate for five out of six staff files reviewed.

Deficiency is cited on the subsequent page of this report (LIC809-D) under the California Code of Regulations, Title 22. The director and district manager were provided a copy of their Appeal Rights (LIC9058) and the district manager's signature on this form acknowledges receipt of these rights. A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the district manager, Teresa Addison.
SUPERVISORS NAME: Seychelle De Luca
LICENSING EVALUATOR NAME: Kyrsten Williams
LICENSING EVALUATOR SIGNATURE: DATE: 03/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/26/2024
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 03/26/2024 11:34 AM - It Cannot Be Edited


Created By: Kyrsten Williams On 03/26/2024 at 10:38 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
, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: LA PETITE ACADEMY - CITRUS HEIGHTS
FACILITY NUMBER: 343600873

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/26/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
04/26/2024
Section Cited
HSC
1596.8662(b)(1)

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1596.8662(b)(1)...a person who...is a employee of a licensed child day care facility shall complete the mandated reporter training...and shall complete renewal mandated reporter training every two years...
This requirement is not met as evidenced by:
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LPA will return to the facility to review staff files.
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Based on record review, the licensee did not comply with the section cited above with updating the mandated reporter training every two years which poses/posed a potential health, safety or personal rights risk to persons 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:Seychelle De Luca
LICENSING EVALUATOR NAME:Kyrsten Williams
LICENSING EVALUATOR SIGNATURE:
DATE: 03/26/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/26/2024


LIC809 (FAS) - (06/04)
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