<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197750091
Report Date: 07/19/2022
Date Signed: 07/19/2022 03:20:50 PM

Document Has Been Signed on 07/19/2022 03:20 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:GUIDEPOST MONTESSORI AT PLUM CANYONFACILITY NUMBER:
197750091
ADMINISTRATOR:AARON BAILEYFACILITY TYPE:
830
ADDRESS:19141 SKYLINE RANCH RDTELEPHONE:
(949) 354-2259
CITY:SANTA CLARITASTATE: CAZIP CODE:
91350
CAPACITY: 54TOTAL ENROLLED CHILDREN: 54CENSUS: 20DATE:
07/19/2022
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
11:45 AM
MET WITH:Thalia Valdovinos, DirectorTIME COMPLETED:
03:30 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
On 07/19/2022, Licensing Program Manager (LPM) Mariela Ramon and Licensing Program Analyst Barbara Beneroso (LPA) met with Director Thalia Valdovinos for the purpose of following up on an unusual incident report submitted to the Department on 06/13/22. During the visit, LPA and LPM toured the facility and took a census of the children present. LPA and LPM observed 20 toddlers with 6 staff members providing supervision.

The incident report indicated that Child #1 who is enrolled in the toddler program was on the playground when he went to kick a ball and his foot rolled over on top of the ball causing him to lose his balance and fall backwards hitting the back of his head on the floor. Based on the information obtained during the interviews conducted with staff and children, it has been determined that child #1's incident was the result of an accident. Staff #1 and #2 statements indicated they observed child #1 falling backwards when he stepped over the ball instead of kicking it, falling and hitting his head. Staff #3 immediately attended child #1 by checking for injuries and applying an ice pack to the back of the head. Child #1 cried due to the fall, however, child was alert and conscious. Child #1 parents were contacted immediately and arrived to the facility shortly after. Parent took child to doctor and was cleared. No signs of head trauma or concussion were found.

Staff handled the situation accordingly by providing first aid and immediately contacting child #1 parents. Staff also provided parent with a written incident report.

The information obtained during the unusual incident follow up revealed no violations were found.
Facility is encouraged to continue to report incidents that occur in the facility.

An exit interview was conducted, a copy of this report was provided along with the notice of site visit.
SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Barbara Beneroso
LICENSING EVALUATOR SIGNATURE: DATE: 07/19/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/19/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 1