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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364819502
Report Date: 04/12/2021
Date Signed: 04/12/2021 10:37:04 AM

Document Has Been Signed on 04/12/2021 10:37 AM - 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:KIDS AND CARE PRESCHOOL AND DAY CARE CENTERFACILITY NUMBER:
364819502
ADMINISTRATOR:CLAUDIA VALENZUELA GARCIAFACILITY TYPE:
850
ADDRESS:9560 I AVETELEPHONE:
(760) 956-5000
CITY:HESPERIASTATE: CAZIP CODE:
92345
CAPACITY: 60TOTAL ENROLLED CHILDREN: 0CENSUS: 22DATE:
04/12/2021
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
08:41 AM
MET WITH:Claudia Valenzuela GarciaTIME COMPLETED:
09:38 AM
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Licensing Program Analyst (LPA) Thompson-Miller, met with Director Claudia Valenzuela Garcia for a Case Management Incident inspection involving an Incident Report dated April 9, 2021. The incident occurred on April 8, 2021. Inspection conducted virtual due to COVID-19.

Description of the incident: Child #1 alleged Child #2 showed private part
Child #1 alleged Child #2 showed him his private part near or in the common area (library area). The focus of the inspection was to conduct interviews with staff and children. LPA was also given a tour of the common area, school age and preschool rooms.

Based on information provided and interviews conducted the incident will require additional information and investigation.

An exit interview was conducted and a copy of this report was read and forwarded to the Director, Claudia Valenzuela Garcia via email and mail for confirmation with "Read Receipt" on this date. The Notice of Site Visit was emailed and mailed to Director.
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Linda Thompson-Miller
LICENSING EVALUATOR SIGNATURE: DATE: 04/12/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/12/2021
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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