Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364815634
Report Date: 03/22/2017
Date Signed 03/22/2017 07:53:52 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME:LA PETITE ACADEMYFACILITY NUMBER:
364815634
ADMINISTRATOR:THERESA SALLEYFACILITY TYPE:
830
ADDRESS:620 BASELINE ROADTELEPHONE:
(909) 874-5113
CITY:RIALTOSTATE: CAZIP CODE:
92376
CAPACITY:8CENSUS: 5DATE:
03/22/2017
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
02:30 PM
MET WITH:Theresa SalleyTIME COMPLETED:
07:50 PM
NARRATIVE
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(2) A random annual visit is being conducted as part of a compliance review. Licensing Program Analyst (LPA), Kim Leung, toured the center, inside and out. The following was observed:
· A review of the staff records and a review of a sampling of children's records were conducted as part of this evaluation
· The licensee is asked to update the following documents, if applicable, and submit to licensing within 30 days:
1. LIC 500 Personnel Report
2. LIC 610 Emergency & Disaster Plan
3. LIC 309 Administrative Organization (only if changes have been made)
· The following items have been posted and are updated where necessary:
- License
- Emergency Disaster Plan (LIC610)
- Parent’s Rights Poster (PUB393)
- Personal Rights (LIC613A)
- Child Car Seat Law
- Menu
· The facility is operating within the terms of the license
· Ratios were met during this visit
· Appropriate supervision was provided during the visit
· All activity areas are physically separated from other components
· Drinking water is provided by using infant bottles and sippy cups inside and outside
· Rooms are equipped with age appropriate furniture and equipment in good condition
SUPERVISOR'S NAME: Aaron RossTELEPHONE: (951) 784-4200
LICENSING EVALUATOR NAME: Kim LeungTELEPHONE: (951) 529-4713
LICENSING EVALUATOR SIGNATURE:

DATE: 03/22/2017
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/22/2017
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME: LA PETITE ACADEMY
FACILITY NUMBER: 364815634
VISIT DATE: 03/22/2017
NARRATIVE
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· Records were reviewed ensuring that the staff files contain documentation of the educational background, training and/or experience required
· Most recent disaster drill was conducted on 3/10/2017 per drill log
· A review of staff records on 3/22/2017 indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.
· Facility is not currently providing IMS - 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
· For more information on SIDS and Safe Sleep Environments, please visit:
California Department of Public Health – California SIDS Program: http://www.cdph.ca.gov/programs/SIDS/pages/default.aspx
AAP – Safe Sleep Campaign: http://www.healthychildcare.org/sids/html
AAP-Free Training: Reducing the Risk of SIDS in Early Education and Child Care: http://shop.aap.org/Reducing-the-Rick-of-SIDS-in-Early-Education-and-Child-Care
And Caring for our Children, Safe Sleep Practices and SIDS/Suffocation Risk Reduction: http://cfoc/nrckids/org/standardview/spccol/safe_sleep

See LIC 809D for deficiencies cited.

The following was also reviewed and discussed:
v AB 2084 - Nutritious Beverages in Child Care Facilities effective January 1, 2012 - was explained that only low-fat or non-fat milk is to be served to children 2 years of age or older; and limit juice to one serving of 100% juice per day; serve no beverages with added sweeteners; and water must be available and accessible to children throughout the day
SUPERVISOR'S NAME: Aaron RossTELEPHONE: (951) 784-4200
LICENSING EVALUATOR NAME: Kim LeungTELEPHONE: (951) 529-4713
LICENSING EVALUATOR SIGNATURE:

DATE: 03/22/2017
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/22/2017
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, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME: LA PETITE ACADEMY
FACILITY NUMBER: 364815634
VISIT DATE: 03/22/2017
NARRATIVE
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· Napping equipment is sufficient for the capacity and meets licensing requirements
· The room is clean and free of hazards
· All floors are kept clean and safe
· No weapons stored at the facility as stated by facility director Theresa Salley
· There are no accessible bodies of water present. Ms. Salley stated that she understood that all wading pools or similar product must be emptied immediately after use and stored in an upright position when not in use.
· No medications stored for children at this time as stated by Ms. Salley
· Hazards are stored inaccessible to infants
· Poisons and toxins are locked
· Infant changing tables contain a padded surface no less than one inch thick and be covered with washable vinyl or plastic; and contain raised sides at least three inches high
· Outdoor play area is physically separated by appropriate fencing and free of hazards
· Outdoor activity areas are supplied with age and size appropriate equipment in good condition
· Kitchen is clean, free of litter, rubbish and free of rodents and other vermin
· Both sinks at the changing station are used for infant food preparation and infant bottle warming and that may cause food contamination
· The areas around or under the slide structure is cushioned with woodchips and Ms. Salley was advised to rake the woodchips back to the foot of the slide to protect children's safety
· Individual feeding plans are NOT available for review
· Infant needs and services plans are NOT available for review
· Sign in/Sign out record was reviewed and meets regulation requirements
· A Staff member is present with current Pediatric CPR/First Aid which expires in May 2017 (Theresa Salley)
· Opening and closing staff member’s CPR/First Aid expires in May 2017 (opening teacher Ana Sanchez and closing teacher Evelyn Collazo)
· Director completed Health and Safety Training in 2001
· Records were reviewed ensuring the children’s files contain the names and contact information of authorized representatives and others who can assume responsibility for the child when necessary
SUPERVISOR'S NAME: Aaron RossTELEPHONE: (951) 784-4200
LICENSING EVALUATOR NAME: Kim LeungTELEPHONE: (951) 529-4713
LICENSING EVALUATOR SIGNATURE:

DATE: 03/22/2017
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/22/2017
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, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME: LA PETITE ACADEMY
FACILITY NUMBER: 364815634
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/22/2017
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/27/2017
Section Cited
101419.3(a)
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Modifications to Infant Needs and Services Plan. Current needs and services plans for the infants in attendance are not available review.
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Director Theresa Salley agreed to ensure that current needs and services plans are accessible to all infant staff members at all times for the staff to review and meet children's needs. Copy of the plans will be submitted to the Department by 3/27/2017.
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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: Aaron RossTELEPHONE: (951) 784-4200
LICENSING EVALUATOR NAME: Kim LeungTELEPHONE: (951) 529-4713
LICENSING EVALUATOR SIGNATURE:

DATE: 03/22/2017
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/22/2017
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, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME: LA PETITE ACADEMY
FACILITY NUMBER: 364815634
VISIT DATE: 03/22/2017
NARRATIVE
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v - AB290 – Child Nutrition, effective January 1, 2016 - In accordance with California Health and Safety Code Section 1596.866 - each child care center shall have at least one person employed who was completed one hour of childhood nutrition training as part of the preventive health practices course or courses.
v - SB792 – Immunization requirements for staff, volunteers, effective September 1, 2016 – In accordance with California Health and Safety Code Section 1597.622 - a person shall not be employed or volunteer at a family day care home if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination or they may provide a statement declining the vaccination. If employees/volunteers are receiving the influenza vaccination they must do so between August 1 and December 1 of each year.
v Access to forms & Regulations for Family Child Care online at www.ccld.ca.gov. Please subscribe to My CCL on our website. Department updates will be sent directly to your e-mail account once you have set up an account.
v The Duty Officer is available to answer questions Monday – Friday at 1-844-LET-US-NO (1-844-538-8766).

An exit interview was conducted with Ms. Salley and during the interview, Ms. Salley confirmed that there are no Registered Sex Offenders living in the facility and/or using the facility address for their mailing address.

A copy of this report was provided to the facility. A NOTICE OF SITE VISIT WAS ISSUED AND IS TO BE POSTED IN A PROMINENT LOCATION AT THE FACILITY FOR THE NEXT 30 DAYS ALONG WITH A COPY OF ALL TYPE A DEFICIENCIES (LIC809D/9099D) CITED DURING THIS VISIT. A COPY OF ALL TYPE A DEFICIENCIES CITED DURING THIS VISIT MUST ALSO BE IMMEDIATELY (within 24 hours of the child’s next day in care) GIVEN TO THE PARENTS OF ALL CHILDREN ENROLLED IN THE CHILD CARE FACILITY AND ANY CHILDREN ENROLLED INTO THE CHILD CARE FACILITY OVER THE NEXT 12 MONTHS. Appeal rights were provided and discussed with Ms. Salley. Ms. Salley's signature on this report acknowledged receipt of LIC9058 Appeal Rights. This report must be available for review, upon request, for the next 3 years.
SUPERVISOR'S NAME: Aaron RossTELEPHONE: (951) 784-4200
LICENSING EVALUATOR NAME: Kim LeungTELEPHONE: (951) 529-4713
LICENSING EVALUATOR SIGNATURE:

DATE: 03/22/2017
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/22/2017
LIC809 (FAS) - (06/04)
Page: 7 of 7


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME: LA PETITE ACADEMY
FACILITY NUMBER: 364815634
VISIT DATE: 03/22/2017
NARRATIVE
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v AB 2621 – Public Information effective January 1, 2015 – The Department shall post licensing information for Child Care Facilities on it’s internet Web site to include:
· The name
· The address for each Child Care Center only
· The status of the license
· The capacity of the license for each Child Care Center only
· The number of site visits, including:
o Non-complaint inspections
o Substantiated and inconclusive complaint inspections
· The number of citations
This information is to be updated at least monthly on the website and will span the preceding five-year period.
v AB 2236 – Civil Penalties, effective July 1, 2015 – Enacts new civil penalties in cases where the Department determines that a violation of licensing standards resulted in the death or serious injury, or constitutes physical abuse of a child in care. The bill establishes an appeal procedure specific to these civil penalties. The bill also expands the scope of the Child Health and Safety Fund in order to assist parents in securing alternative child care when a Child Care Center license has been suspended or revoked. These civil penalty amounts are scaled in relation to the total capacity of all of the licensee’s facilities and not just the specific facility cited or limited to that facility type.
v AB 2386 – Carbon Monoxide Detector Regulations, effective January 1, 2015 – In accordance with California Health and Safety Code Section 1975.543 - Every child care center shall have one or more carbon monoxide detectors in the facility that meet the standards established in Chapter 8 (commencing with Section 13260) of Part 2 of Division 12. The department shall account for the presence of these detectors during inspections
v - SB 277 – Immunizations, Personal Beliefs Exemption, effective January 1, 2016 - it eliminates the exemption from existing specified immunization requirements based upon personal beliefs, and only allows an exemption from future immunization requirements deemed appropriate by the State Department of Public Health or a medical professional for medical reasons.
SUPERVISOR'S NAME: Aaron RossTELEPHONE: (951) 784-4200
LICENSING EVALUATOR NAME: Kim LeungTELEPHONE: (951) 529-4713
LICENSING EVALUATOR SIGNATURE:

DATE: 03/22/2017
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/22/2017
LIC809 (FAS) - (06/04)
Page: 6 of 7


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME: LA PETITE ACADEMY
FACILITY NUMBER: 364815634
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/22/2017
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
03/23/2017
Section Cited
101439(l)
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Infant Care Center Fixtures, Furniture, Equipment and Supplies. Toys shall be safe. Section 101427(o)Infant Care Food Service. Infants shall not be bathed in, and diapers or clothing shall not be rinsed in, the food-preparation area. Section 101439(h)(5)Infant Care Center Fixtures, Furniture, Equipment and Supplies.
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Director Theresa Salley agreed to ensure that one of the sinks would not be used for food preparation and food container cleaning. Ms. Salley agreed to designate one of the sinks for diapering only. Written statement of understanding with all staff signatures will be submitted to the Department by 3/23/2017.
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Infant changing tables shall not be located in the kitchen/food-preparation area. LPA observed that both sinks at the changing station are used for infant food preparation and infant bottle warming and that may cause food contamination
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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: Aaron RossTELEPHONE: (951) 784-4200
LICENSING EVALUATOR NAME: Kim LeungTELEPHONE: (951) 529-4713
LICENSING EVALUATOR SIGNATURE:

DATE: 03/22/2017
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/22/2017
LIC809 (FAS) - (06/04)
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