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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197413766
Report Date: 02/18/2022
Date Signed: 02/18/2022 02:08:18 PM

Document Has Been Signed on 02/18/2022 02:08 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
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME:TUTOR TIME CHILD CARE/LEARNING CENTERFACILITY NUMBER:
197413766
ADMINISTRATOR:WENDY POWELLFACILITY TYPE:
850
ADDRESS:29421 THE OLD ROADTELEPHONE:
(661) 295-1234
CITY:CASTAICSTATE: CAZIP CODE:
91384
CAPACITY: 120TOTAL ENROLLED CHILDREN: 120CENSUS: 70DATE:
02/18/2022
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
11:04 AM
MET WITH:Wendy PowellTIME COMPLETED:
02:20 PM
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On 02/18/22,at 11:04 AM Licensing Program Analyst (LPAs) Leandra Dolliole and Liana Stepanyan met with Director Wendy Powell and Assistant Director Rubi Trejo to conduct an unannounced case management inspection to follow-up on a self- reported unusual incident report submitted by the facility on 02-14-22. Upon arrival, LPA's observed 70 children and 14 staff members.

Description of incident: On 02-10-22 at approximately 12pm Child #1 was taken by the arm and roughly placed down on the cot during nap time by staff #1.

Based on the information gathered from observations, record review and interviews conducted with the children and Director additional follow up is needed.

Exit interview was conducted, report was read, and a copy of this report was sent to the facility director via email along with the appeal rights and notice of site visit.

SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Liana Stepanyan
LICENSING EVALUATOR SIGNATURE: DATE: 02/18/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/18/2022
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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