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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 566210590
Report Date: 10/05/2022
Date Signed: 10/05/2022 03:32:47 PM

Document Has Been Signed on 10/05/2022 03:32 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, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME:LA PETITE ACADEMYFACILITY NUMBER:
566210590
ADMINISTRATOR:REBECCA DELGADOFACILITY TYPE:
830
ADDRESS:261 W. STANLEYTELEPHONE:
(805) 652-0917
CITY:VENTURASTATE: CAZIP CODE:
93001
CAPACITY: 24TOTAL ENROLLED CHILDREN: 24CENSUS: 18DATE:
10/05/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:06 PM
MET WITH:Rebecca HernandezTIME COMPLETED:
03:49 PM
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On October 5, 2022 at 01:06 PM, Licensing Program Analyst (LPA) Rona Chavez conducted a Required Annual inspection. LPA met with Director Rebecca Hernandez and advised her the purpose of the inspection. Director provided LPA a tour of the facility inside and out. There were 18 children in care at the time of the inspection with five (5) staff providing care.

The center operates from 6:30 AM to 6:30 PM Monday thru Friday. This is a combination center with a pre-school and school age program. All required licensing forms were posted in the lobby of the center. LPA observed menu and activity schedule posted in the lobby and the classrooms. The center uses two (2) classrooms for the infant program. The restrooms were found clean and free of toxins. LPA observed a working carbon monoxide/smoke detector. LPA observed age appropriate furniture, equipment and toys in the class rooms. There was a diaper changing tables within an arm's reach to the sink. The refrigerator had each child's formula, sipping cups and bottles in their own labeled tray. Facility has sufficient amount of cribs and the older infants use mats for nap time. LPA observed safe sleep regulations were being met and fifteen minute check was documented and posted in the classroom. The outdoor play area is completely fenced and LPA observed age appropriate toys, equipment and shade. Center provides Breakfast, Lunch and snack. Drinking water is available inside and outside.

Center uses electronic sign in sheet App/Kiosk Learning Care Works. Teacher files reviewed and were found complete with State required forms. Teacher's Medical Health Records verified. Teachers are current with CPR and First Aid which expires 5/2023. Center staff completed Mandated Reporter Training and has an expiration date of 3/23/2023. Children's files reviewed and found complete. Each child had their infant needs and services plan as well as their own individual feeding plan. Center is not currently providing IMS.

Cont on 809C
SUPERVISORS NAME: Ana Tolentino
LICENSING EVALUATOR NAME: Rona Chavez
LICENSING EVALUATOR SIGNATURE: DATE: 10/05/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/05/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME: LA PETITE ACADEMY
FACILITY NUMBER: 566210590
VISIT DATE: 10/05/2022
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To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.

Director was reminded that all adults 18 and over, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

LPA discussed the safe sleep regulations with director and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed director of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, an updated Plan of Operation that includes IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

SUPERVISORS NAME: Ana Tolentino
LICENSING EVALUATOR NAME: Rona Chavez
LICENSING EVALUATOR SIGNATURE:

DATE: 10/05/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/05/2022
LIC809 (FAS) - (06/04)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME: LA PETITE ACADEMY
FACILITY NUMBER: 566210590
VISIT DATE: 10/05/2022
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No deficiencies were cited during today's visit.

A notice of site visit was given and must remain posted for 30 days.

Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with Director Rebecca Hernandez.

SUPERVISORS NAME: Ana Tolentino
LICENSING EVALUATOR NAME: Rona Chavez
LICENSING EVALUATOR SIGNATURE:

DATE: 10/05/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/05/2022
LIC809 (FAS) - (06/04)
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