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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197750082
Report Date: 05/21/2024
Date Signed: 05/21/2024 03:10:12 PM

Document Has Been Signed on 05/21/2024 03:10 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:TINKER VILLAGEFACILITY NUMBER:
197750082
ADMINISTRATOR/
DIRECTOR:		ERICKA DIAZFACILITY TYPE:
850
ADDRESS:41955 50TH STREET WEST #103TELEPHONE:
(661) 718-3081
CITY:QUARTZ HILLSSTATE: CAZIP CODE:
93536
CAPACITY: 30TOTAL ENROLLED CHILDREN: 30CENSUS: 25DATE:
05/21/2024
TYPE OF VISIT:Case Management - Health ChecksUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:03 PM
MET WITH:Kaitlyn TaylorTIME VISIT/
INSPECTION COMPLETED:
03:30 PM
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On 5/21/2024, Licensing Program Analyst (LPA) Carol Heath conducted an unannounced case management visit to verify that the licensee remains in substantial compliance with the health and safety standards required by regulations governing the Childcare Center. LPA met with Lead Teacher Kaitlyn Taylor. At the time of entry, LPA observed 25 preschool children in care and 5 staff members providing care and supervision. Facility operational hours are Monday through Friday from 7:00 a.m. to 5:00 p.m.

The purpose of the visit is to conduct interviews with teachers and other related parties. In addition, LPA follow up on the Type A citation that was given on 4/30/2024. Upon receipt of a Type A deficiency, a copy of the licensing report must also be posted for 30 days. The licensee must obtain a signed Acknowledgement of Licensing Reports (LIC 9224) from the parent/guardian and place it in each child's file.
LPA reviewed Teacher #1—Teacher #4's personal information and children’s files and LPA also received the facility roster.

The facility was not in compliance with Title 22 regulations, and Type B deficiencies was cited during today's visit.

An exit interview was conducted, and the report was reviewed with the Lead Teacher, Kaitlyn Taylor.
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Carol Heath
LICENSING EVALUATOR SIGNATURE: DATE: 05/21/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/21/2024
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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Document Has Been Signed on 05/21/2024 03:10 PM - It Cannot Be Edited


Created By: Carol Heath On 05/21/2024 at 01:38 PM
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: TINKER VILLAGE
FACILITY NUMBER: 197750082

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/21/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
05/24/2024
Section Cited
HSC
1596.8595(c)(1)

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(c)(1) A licensed child day care facility shall provide to the parents or guardians of each child receiving services in the facility copies of any licensing report that documents any Type A citation that represents an immediate risk to the health, safety, or personal rights of
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The lead teacher will have each family fill out LIC 9224 and email to LPA by 5/24/2024.
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children in care as set forth in paragraph (1) of subdivision (a) of Section 1596.893b. This requirement is not meet as evidenced by:Based on interview and record review, the facility does not let parent sign the LIC Which poses an potential Health, Safety, or Personal Rights risk to persons 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: 05/21/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/21/2024


LIC809 (FAS) - (06/04)
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