<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 153808177
Report Date: 02/21/2023
Date Signed: 02/21/2023 03:40:09 PM

Document Has Been Signed on 02/21/2023 03:40 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
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME:OASIS CHILD DEVELOPMENT CENTERFACILITY NUMBER:
153808177
ADMINISTRATOR:BENCOMA, CARLEENFACILITY TYPE:
850
ADDRESS:814 NORTH NORMA STREETTELEPHONE:
(760) 371-1469
CITY:RIDGECRESTSTATE: CAZIP CODE:
93555
CAPACITY: 100TOTAL ENROLLED CHILDREN: 100CENSUS: 29DATE:
02/21/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
01:20 PM
MET WITH:Site Supervisor-Carleen BencomaTIME COMPLETED:
04:00 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
On 02/21/23, Licensing Program Analysts (LPAs) Andrea Pittman and Justeene Tamayo met with Site Supervisor, Carleen Bencoma for the purpose of following up on an Unusual Incident Report that occurred on 02/08/23 and and was reported to the Department on 02/09/23 . Upon arrival, LPAs observed 29 preschool children with 6 staff.

The incident reported indicated on 02/08/23 child #1 pulled child #2 pants down in an inappropriate manner.

Based on the information gathered from interviews conducted with staff and Site Supervisor, as well as video footage obtained from the day of the incident, it was determined that further follow up is needed. LPAs obtained children and staff's roster as well as other supportive documentation.

Site Supervisor Carleen Bencoma was advised an unannounced visit will be conducted at a later date.

Exit Interview conducted and a copy of this report was provided to Site Supervisor Carleen Bencoma, along with her appeal rights and notice of site visit.

SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Andrea Pittman
LICENSING EVALUATOR SIGNATURE: DATE: 02/21/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/21/2023
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 1