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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 444416436
Report Date: 08/11/2022
Date Signed: 08/11/2022 04:00:35 PM

Document Has Been Signed on 08/11/2022 04:00 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, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME:L'ACADEMY PRESCHOOL SANTA CRUZFACILITY NUMBER:
444416436
ADMINISTRATOR:NOLAN, KARENFACILITY TYPE:
830
ADDRESS:3205 SALISBURY DRIVETELEPHONE:
(415) 361-1879
CITY:SANTA CRUZSTATE: CAZIP CODE:
95065
CAPACITY: 13TOTAL ENROLLED CHILDREN: 9CENSUS: 8DATE:
08/11/2022
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
03:18 PM
MET WITH:Corina HernandezTIME COMPLETED:
04:06 PM
NARRATIVE
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Licensing Program Analyst (LPA), Cortney Nelson, met with staff member, Corina Hernandez, and explained purpose of today's visit. Upon arrival, there were 9 infants and 3 teachers present. Corina states that Site Director, Lanie Choi, is on vacation and will return to the facility on 8/18/2022. Corina is acting as site director during Lanie's vacation.

Purpose of today's visit is to follow-up on deficiencies cited during annual inspection on 7/25/2022 with a due date of 8/5/2022. Site Director submit extension request on 8/4/2022 to be reviewed by Licensing Program Manager (LPM) Joel Segura, however extension request was denied.

Previous Licensing Report (LIC809) dated 7/25/2022 gave notice that failure to correct would result in a civil penalty. Because correction was not made by 8/5/2022, three civil penalties of $100 per violation per day will be assessed until violation is corrected.

During todays inspection, LPA received document to clear one of three deficiencies.

Exit interview conducted with staff member, Corina Hernandez.

As a results of todays inspection, no deficiencies were cited.

A NOTICE OF SITE VISIT WAS GIVEN AND MUST BE POSTED FOR 30 DAYS.
SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Cortney Nelson
LICENSING EVALUATOR SIGNATURE: DATE: 08/11/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/11/2022
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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