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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 153801788
Report Date: 02/28/2024
Date Signed: 02/28/2024 09:14:05 AM

Document Has Been Signed on 02/28/2024 09:14 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
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME:CERRO COSO CHILD DEVELOPMENT CENTER-CAL CITYFACILITY NUMBER:
153801788
ADMINISTRATOR:KRALL, JESSICAFACILITY TYPE:
850
ADDRESS:10179 HEATHER AVENUETELEPHONE:
(760) 373-1070
CITY:CALIFORNIA CITYSTATE: CAZIP CODE:
93505
CAPACITY: 27TOTAL ENROLLED CHILDREN: 27CENSUS: 0DATE:
02/28/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
09:03 AM
MET WITH:Tiffany RobertsonTIME COMPLETED:
09:25 AM
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On 02/28/2024, licensing program analyst (LPA) Carol Heath and Sherell Braddock met with the Site Supervisor, Tiffany Robertson, to deliver the findings of the Case Management - Incident investigation involving an unusual incident Report (UIR) received by telephone on 1/16/2024. Upon arrival, LPA observed 0 care children were present with the site supervisor. The facility is closed due to the repair.

The investigation was conducted by the Community Care Licensing Investigations Bureau, Investigator Edward Hector. The investigation consisted of interviews with the facility staff, child, parents, and other relevant parties. The investigation revealed inconsistent statements. The allegation could not be corroborated. Therefore, the allegations have been found unsubstantiated.

Based on the interview conducted, the incident does not appear to have been the result of any violation of the Title 22 regulation. Therefore, no deficiencies were cited.

An exit interview was conducted, and a copy of the report was read and provided to the Site Director, Tiffany Robertson.
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Carol Heath
LICENSING EVALUATOR SIGNATURE: DATE: 02/28/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/28/2024
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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