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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197410439
Report Date: 06/28/2022
Date Signed: 06/28/2022 10:24:49 AM

Document Has Been Signed on 06/28/2022 10:24 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:LEAPS AND BOUNDSFACILITY NUMBER:
197410439
ADMINISTRATOR:JESSICA KIEFFERFACILITY TYPE:
830
ADDRESS:2026 E. AVENUE QTELEPHONE:
(661) 272-4611
CITY:PALMDALESTATE: CAZIP CODE:
93550
CAPACITY: 18TOTAL ENROLLED CHILDREN: 18CENSUS: 0DATE:
06/28/2022
TYPE OF VISIT:OfficeANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Jessica KiefferTIME COMPLETED:
10:30 AM
NARRATIVE
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Licensing Program Analyst (LPA) Carol Heath and Licensing Program Manager (LPM) Claretta Yates met with Director Jessica Kieffer to discuss best practices for the operation of the Child Care Center. The goal of this meeting is for the Licensee to achieve and maintain compliance with the Title 22 California Code of Regulations. This meeting was conducted in Palmdale Regional Office (RO). Description of the incident: On 06/15/22, the Regional Office received a phone call from Director Jessica Kieffer reporting an unusual incident that involved law enforcement. The center was placed on lockdown due to a threat being made against an employee and the school.

On 06-10-22 staff #, 1 told staff #2 that her ex-boyfriend is crazy and said he was going to shoot up the school. Staff #2 text Director Jessica on the night of 06-14-22 to report the incident. It was revealed that Staff #1 boyfriend had been following her and he called her at the school saying that he was going to shoot down the school.

During today's meeting, the following was discussed:

1)The Operation of a Child Care Center, Title 22, Division 12 (Website). 2) Reporting requirements 101212 (d): Upon the occurrence, during the operation of the child care center of any of the events specified in (d)(1) below, a report shall be made to the Department by telephone or fax within the Department’s next working day and during its normal business hours. In addition, a written report containing the information specified in (d)(2) below shall be submitted to the Department within 7 days following the occurrence of such an event. 3) Active Shooter Preparedness (CISA), Handout 4) Lockdown Drill (process and check List) 5) Plane of Action

Based on the interview and record review, Staff #2 was aware of the threat against the school on 6/10/22 and failed to report it immediately. Staff #2 reported the incident on 06/14//22. Therefore, this facility is being cited for Reporting Requirement Section 101212 (d)

Type B Deficiency cited: See LIC 809-D.


An exit interview was conducted: A copy of the report was discussed and given to Director Jessica Kieffer.
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Carol Heath
LICENSING EVALUATOR SIGNATURE: DATE: 06/28/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/28/2022
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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Document Has Been Signed on 06/28/2022 10:24 AM - It Cannot Be Edited


Created By: Carol Heath On 06/28/2022 at 09:57 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: LEAPS AND BOUNDS
FACILITY NUMBER: 197410439

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/28/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/05/2022
Section Cited
CCR
101212(d)

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101212(d) Reporting Requirements: Upon the occurrence, during the operation of the child care center of any of the events specified in (d)(1) below, a report shall be made to the Department by telephone or fax within the Department's next working day and during its normal business hours.
In addition, a written report containing the information specified in (d)(2) below shall be submitted to the Department within seven days following the occurrence of such event. This requirement is not met as evidenced by:

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The director will share this regulation with all staff. The center already practiced the lock down drill on 6/23/2022 with all the children and staff. After the director finishs the training, she will email the sign in/out, aganda and any informatiom to LPA by 7/5/2022.
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Based on the interview and record review, Staff #2 was aware of the threat against the school on 6/10/22 and failed to report it immediately. Staff #2 reported the incident on 06/14/22 which poses potential health, safety, or personal rights risk to children in care.

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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:Claretta Yates
LICENSING EVALUATOR NAME:Carol Heath
LICENSING EVALUATOR SIGNATURE:
DATE: 06/28/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/28/2022


LIC809 (FAS) - (06/04)
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