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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197415187
Report Date: 10/22/2024
Date Signed: 10/22/2024 03:39:24 PM

Document Has Been Signed on 10/22/2024 03:39 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:CADENCE ACADEMY PRESCHOOLFACILITY NUMBER:
197415187
ADMINISTRATOR/
DIRECTOR:		JACQUELINE MAJORFACILITY TYPE:
840
ADDRESS:27630 NEWHALL RANCH ROADTELEPHONE:
(661) 294-1970
CITY:VALENCIASTATE: CAZIP CODE:
91355
CAPACITY: 144TOTAL ENROLLED CHILDREN: 144CENSUS: 33DATE:
10/22/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:30 PM
MET WITH:Director Jackie TIME VISIT/
INSPECTION COMPLETED:
04:00 PM
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On 10/22/2024, Licensing Program Analyst (LPA) Alemoh met with Director Jackie for the purpose of concluding the self-reported unusual incident that was received by the Palmdale Regional Office on 10/10/2024 that occurred on the same day. LPA toured the facility and observed 33 children present along with 4 staff.

On 10/10/2024 the facility reported an Unusual Incident concerning child #1 was playing on the playground on the monkey bars to which he fell on his arm. Interviews with staff, parents, and other complaint relevant parties including the review of supportive documentation and records.

Interviews revealed in that there were two staff members at the time of the incident providing care and supervision of C1. Staff members were stationed next to the monkey bars area to which they observed the incident that occurred. Video evidence was observed in that Staff #1, and #2 went to check up on C1 immediately after the incident had occurred. Staff members were observed providing first aid to C1 to which staff members brought C1 back into the facility to apply an ice pack on C1 arm. Parents were called and notified for pick up.

SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Andrew Alemoh
LICENSING EVALUATOR SIGNATURE: DATE: 10/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/22/2024
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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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: CADENCE ACADEMY PRESCHOOL
FACILITY NUMBER: 197415187
VISIT DATE: 10/22/2024
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No deficiency will be cited today. Licensee is encouraged to continue to report unusual incidents to the Palmdale Regional Office.

An exit interview was conducted, and a copy of this report was read and provided to the licensee on this date, along with a copy of her appeal rights and Notice of Site Visit.

SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Andrew Alemoh
LICENSING EVALUATOR SIGNATURE:

DATE: 10/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/22/2024
LIC809 (FAS) - (06/04)
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