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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197750004
Report Date: 09/25/2024
Date Signed: 09/25/2024 01:40:24 PM

Document Has Been Signed on 09/25/2024 01:40 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:LEONA COX STATE PRESCHOOLFACILITY NUMBER:
197750004
ADMINISTRATOR/
DIRECTOR:		MILITZA GARCIAFACILITY TYPE:
850
ADDRESS:18643 OAKMOOR STREETTELEPHONE:
(661) 252-2100
CITY:CANYON COUNTRYSTATE: CAZIP CODE:
91351
CAPACITY: 24TOTAL ENROLLED CHILDREN: 24CENSUS: 17DATE:
09/25/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:50 AM
MET WITH:Site Supervisor Militza Garcia TIME VISIT/
INSPECTION COMPLETED:
12:00 PM
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On 09/25/2024, Licensing Program Analyst (LPA) Alemoh met with site supervisor for the purpose of concluding the self-reported unusual incident that was received by the Palmdale Regional Office on 09/20/2024. LPA toured the facility and observed 17 children present along with 4 staff and site supervisor on the premises.

On 09/20/2024 the site supervisor reported an Unusual Incident concerning child #1 was running on the playground when he than tripped over his own feet and fell. C! was limping and seemed to have injure his leg. Interviews with staff, children, along with the review of supportive documentation and records.

Interviews revealed that C1 does trip and fall on his own feet due to the way C1 currently walks on his tip-toes. Statements from staff and parents revealed that this is not an unusual occurrence with C1 in that C1 does trip and fall on his own feet outside of the facility. An IPP Plan was observed in the child file. Child also is receiving other services along with being evaluated by an orthopedic doctor in the near future. Teachers and staff were providing observation and supervision to C1 at the time of the incident.

LPA did observe C1 in the classroom to be walking along with running around the classroom. No signs of marks and or injuries/limping to the child leg.

SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Andrew Alemoh
LICENSING EVALUATOR SIGNATURE: DATE: 09/25/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/25/2024
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: LEONA COX STATE PRESCHOOL
FACILITY NUMBER: 197750004
VISIT DATE: 09/25/2024
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No deficiency will be cited today concerning the injury and or lack of supervision. 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: 09/25/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/25/2024
LIC809 (FAS) - (06/04)
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