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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364815206
Report Date: 12/07/2022
Date Signed: 12/07/2022 02:47:25 PM

Document Has Been Signed on 12/07/2022 02:47 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: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: 35DATE:
12/07/2022
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
10:46 AM
MET WITH:Facility Representative Lisa Burtner TIME COMPLETED:
03:00 PM
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On December 7, 2022 at 10:45am Licensing Program Analyst (LPA) Zirbes, met with Facility Representative Lisa Burtner to conduct an unannounced case management inspection. The purpose of the case management was to follow up on two self-reported unusual incident reports (UIR) submitted on to the Department on November 17, 2022. The unusual incident reports were regarding two incidents. One incident occurred on November 16, 2022 and involved child 1 (C1) biting child 2 (C2). The second incident occurred on November 17, 2022 and involved C1 biting child 3 (C3) twice on November 17, 2022.

During this inspection, interviews were conducted with four staff members. In addition, LPA reviewed staff and children files. Furthermore, LPA also completed a safety inspection of the Center.

Based confidential interviews and record review at this time, the incident does not appear to have been the result of a violation of the Title 22 regulations. LPA provided technical assistance to the Center regarding children who bite.



A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with facility representative Lisa Burtner .
SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Kendal Zirbes
LICENSING EVALUATOR SIGNATURE: DATE: 12/07/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/07/2022
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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