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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376600091
Report Date: 10/06/2022
Date Signed: 10/06/2022 01:46:06 PM

Document Has Been Signed on 10/06/2022 01:46 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
CCLD Regional Office, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME:LA PETITE ACADEMY, INC. - INFANTSFACILITY NUMBER:
376600091
ADMINISTRATOR:KRISTEN COBBFACILITY TYPE:
830
ADDRESS:795 CORRAL CANYON ROADTELEPHONE:
(619) 421-5238
CITY:BONITASTATE: CAZIP CODE:
91902
CAPACITY: 34TOTAL ENROLLED CHILDREN: 34CENSUS: 11DATE:
10/06/2022
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
12:50 PM
MET WITH:Kristen CobbTIME COMPLETED:
01:45 PM
NARRATIVE
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On 10/06/2022 at 12:50 PM, Dana Stevens made an unannounced CASE MANAGEMENT inspection, for reported Lead Exceedance. LPA met with Director Kristen Cobb. Facility was within ratio & capacity. LPA interviewed director and examined the water sources (spigots) deemed at Action Level Exceedance.

Spigots reported with 5.5 ppb or greater lead exceedance levels are as follows:

Toddlers 1 room outside spigot O (not for children use) 5.650 ppb
Infants room outside spigot P (not for children use) 50.700 ppb

Director stated that spigots have already been replaced and are being flushed every four hours for 30 seconds as directed. Director stated they will be retested in 3 weeks time. Director states that both spigots are never used in any way for child care. All spigots inside the facility are not in exceedance. All staff have been informed not to use spigots in exceedance for any reason.

See LIC809D for Type B deficiency cited.

Exit interview conducted. Appeal rights were discussed and given to director on this date. Notice of Site Visit was given to director and must be posted for 30 days.
SUPERVISORS NAME: Cynthia Gray
LICENSING EVALUATOR NAME: Dana Stevens
LICENSING EVALUATOR SIGNATURE: DATE: 10/06/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/06/2022
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 10/06/2022 01:46 PM - It Cannot Be Edited


Created By: Dana Stevens On 10/06/2022 at 01:32 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
, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108

FACILITY NAME: LA PETITE ACADEMY, INC. - INFANTS
FACILITY NUMBER: 376600091

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/06/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Request Denied
Type B
11/07/2022
Section Cited

101700.3(b)(1)

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101700.3(b)(1) Written Directives: A result with values of 5.5 ppb or greater shall be deemed an Action Level Exceedance.
This requirement is not met as evidenced by:

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Spigots have been replaced and are not in use. Spigots are routinely flushed as required. A second testing will be completed in three weeks and Director will provide LPA with the results.
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Based on water testing results and interview, facility tested over the Action Level Exceedance level at two water outlets (spigots). This may pose a health, safety or personal rights 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:Cynthia Gray
LICENSING EVALUATOR NAME:Dana Stevens
LICENSING EVALUATOR SIGNATURE:
DATE: 10/06/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/06/2022


LIC809 (FAS) - (06/04)
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