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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197750097
Report Date: 10/10/2024
Date Signed: 10/10/2024 12:42:24 PM

Document Has Been Signed on 10/10/2024 12:42 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:LEARNING EXPERIENCE, THEFACILITY NUMBER:
197750097
ADMINISTRATOR/
DIRECTOR:
PARAG LADDHAFACILITY TYPE:
850
ADDRESS:24615 COPPER HILL DRIVETELEPHONE:
(661) 904-9530
CITY:SANTA CLARITASTATE: CAZIP CODE:
91354
CAPACITY: 132TOTAL ENROLLED CHILDREN: 132CENSUS: 83DATE:
10/10/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:00 AM
MET WITH:Director Shirley KingTIME VISIT/
INSPECTION COMPLETED:
01:00 PM
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On 10/10/2024, Licensing Program Analyst (LPA) Andrew Alemoh and Center Specialist (CS) Donna Maddox met with Director Shirley and Assistant Director(AA) for the purpose of following up on a self-reported unusual incident that was received by the Palmdale Regional Office on 07/19/2024. LPA toured the facility and observed 83 children w/ 11 toddlers children present, with 22 staff members.

On 07/19/2024 the assistant director reported an Unusual Incident concerning C1 body was shaking and had got a seizure. Interviews with the directors, as well as including the review of supportive documentation and records. During the time of the incident there were 3 teachers present, and the front desk worker.

Interviews revealed that the Director and AA(Assistant Director) were observing and supervising C1 at the time of the incident. Facility representatives were providing C1 a safe environment and support for C1 during the time of the incident. Directors, and staff followed the guidelines of the child IMS plan. Parents were called and notified of the incident that had occurred. Per director statements the mother of C1 trained the Directors in administering medication to C1. No deficiency will be cited today, the facility handled the situation and followed the IMS plan for C1. Licensee is encouraged to continue to report unusual incidents to the Palmdale Regional Office as required.

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