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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364815206
Report Date: 10/06/2021
Date Signed: 10/06/2021 03:51:21 PM

Document Has Been Signed on 10/06/2021 03:51 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:MC DONALD LEARNING CENTERFACILITY NUMBER:
364815206
ADMINISTRATOR:LILIA VOLLAIREFACILITY TYPE:
850
ADDRESS:1017 HOLDEN AVENUETELEPHONE:
(909) 585-6848
CITY:BIG BEAR CITYSTATE: CAZIP CODE:
92314
CAPACITY: 60TOTAL ENROLLED CHILDREN: 60CENSUS: 27DATE:
10/06/2021
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
02:15 PM
MET WITH:Administrator, Lilia Vollaire TIME COMPLETED:
04:00 PM
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On October 6, 2021 at 2:15pm, Licensing Program Analyst (LPA) Kendal Zirbes met with Administrator Lilia Vollaire to conduct an unannounced case management inspection. The purpose of the case management was to follow up on a self-reported unusual incident report submitted to the Department on September 15, 2021. The unusual incident report was regarding an aggressive act between child 1 (C1), child 2 (C2), and child 3 (C3) . (Refer to confidential name list, LIC 811 dated October 6, 2021). Upon arrival, there were 27 children and four teachers and four aides present at the facility.

During this inspection LPA conducted two staff interviews and two confidential interviews. In addition, during the inspection, LPA obtained documentation related to the case management incident.

Due to the need to gather additional information, this investigation is being extended.

A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the Administrator, Lilia Vollaire

SUPERVISORS NAME: Carissa Bell
LICENSING EVALUATOR NAME: Kendal Zirbes
LICENSING EVALUATOR SIGNATURE: DATE: 10/06/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/06/2021
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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