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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197403180
Report Date: 10/03/2023
Date Signed: 10/03/2023 10:14:40 PM

Document Has Been Signed on 10/03/2023 10:14 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:KIDS FIRST LEARNING CENTERFACILITY NUMBER:
197403180
ADMINISTRATOR:CYNTHIA SAENZFACILITY TYPE:
850
ADDRESS:13215 KELOWNA STREETTELEPHONE:
(818) 897-5427
CITY:PACOIMASTATE: CAZIP CODE:
91331
CAPACITY: 214TOTAL ENROLLED CHILDREN: 214CENSUS: 29DATE:
10/03/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
01:50 PM
MET WITH:Eloise Ortiz, Director, Gloria Mancilla Supervisor and David Diaz, Fiscal AdministratorTIME COMPLETED:
05:10 PM
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On October 03, 2023 Licensing Program Analyst (LPA) Isabel Ortega met with
facility Director Eloise Ortiz, Site Supervisor, Gloria Mancilla and David Diaz, fiscal Administrator to conduct a Case Management- Incident inspection. The purpose of the case management was to follow up on a self reported unusual incident report (UIR) called in to the Department on 9/29/2023. This unusual incident report is regarding Child #1 crying and complaining of neck pain(onset) during care.
Upon arrival, there were 29 children observed in care and 5 staff proving care and
supervision.
This inspection was unannounced, during this inspection LPA was provided with
the facility roster. In addition, LPA completed a safety inspection of the facility
including classroom #10. LPA toured a total of two classrooms.

Interviews were conducted with staff, parents and children. Interviews disclosed
staff were providing visual observation when incident occurred. According to
interviews child #1 was hurt on the left side neck by another child in care Child #2.
According to interviews child #2 hit child #1 with his hand holding a piece of apple
on the left side of the neck. According to medical report and x-ray results from a
medical professional states child #1's left side neck had inflammation.
SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Isabel Ortega
LICENSING EVALUATOR SIGNATURE: DATE: 10/03/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/03/2023
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
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: KIDS FIRST LEARNING CENTER
FACILITY NUMBER: 197403180
VISIT DATE: 10/03/2023
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According to interviews facility was not able to provide any further details about the incident other than children were playing with their snack(apples) and child #1 accidentally dropped child #2's apple on the floor and child #1 bend down to reach the piece of apple.

Base on the information gathered, LPA has concluded staff provided adequate supervision. Child #2 admitted to hitting Child #1 on the neck with a closed hand holding a piece of apple in his hand. Staff #1 was sitting at the table with the children during snack when incident occurred. Child #1's symptoms were delayed until Child #1 was at the carpet for story time. Child's legal representative was contacted and child#1 was picked up shortly after. A total of 3 teachers were in the classroom and 17 children at the time of the incident. Teachers were in zoning position at time of incident.


Copy of this report, appeal rights and Notice of site visit was provided to Supervisor on this day.
SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Isabel Ortega
LICENSING EVALUATOR SIGNATURE:

DATE: 10/03/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/03/2023
LIC809 (FAS) - (06/04)
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