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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364819502
Report Date: 01/04/2023
Date Signed: 01/04/2023 04:46:51 PM

Document Has Been Signed on 01/04/2023 04:46 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: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: 60CENSUS: 50DATE:
01/04/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
03:00 PM
MET WITH:Katrina Henderson, Assistant DirectorTIME COMPLETED:
04:45 PM
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On January 4, 2023, at 11:00 am Licensing Program Analysts (LPA), Kuliema Calloway made an unannounced inspection to the facility Kids and Care Preschool and Day Care Center, for the purpose of conducting a Case Management inspection to address concerns regarding in incident report that was received on 12/29/22 stating the following:

On Friday, 12/28/2022, On Call Duty Worker (OD Desk) received a call from licensee stating a Child (C1) stated they were pushed down by another child. Staff (S1) observed sand on C1’s clothes, calmed C1 down, and father picked C1 up shortly after. Father took C1 home and called day-care to say C1 was going to be taken to the hospital for their elbow that looked out of place. Licensee called for an update and was told the doctors may need to put a pin in C1’s elbow and would contact the day care when there is more information.

LPA arrived and observed ten (10) Staff and fifty (50) Children in care.

LPA obtained a copy of the child care facility roster. IB will conduct a further investigation.

Exit interview was conducted with the S1 and a copy of this report and appeal rights were left at the facility with S1.

SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Kuliema Calloway
LICENSING EVALUATOR SIGNATURE: DATE: 01/04/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/04/2023
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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