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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364819502
Report Date: 11/22/2024
Date Signed: 11/22/2024 01:48:39 PM

Document Has Been Signed on 11/22/2024 01:48 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:KIDS AND CARE PRESCHOOL AND DAY CARE CENTERFACILITY NUMBER:
364819502
ADMINISTRATOR/
DIRECTOR:		CLAUDIA VALENZUELA GARCIAFACILITY TYPE:
850
ADDRESS:9560 I AVETELEPHONE:
(760) 956-5000
CITY:HESPERIASTATE: CAZIP CODE:
92345
CAPACITY: 60TOTAL ENROLLED CHILDREN: 60CENSUS: 33DATE:
11/22/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:03 AM
MET WITH:Katrina Henderson, DirectorTIME VISIT/
INSPECTION COMPLETED:
02:34 PM
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On 11/22/2024, Licensing Program Analyst (LPA) Justeene Tamayo met with Director, Katrina Henderson, who granted access to the facility. The purpose of the inspection was to conduct an unannounced case management inspection for a UIR received at Palmdale RO on 11/18/2024. When LPA arrived at the facility there were 33 preschool age children in care, with 4 teachers.

Description of Incident: On 11/14/24, child #2 was pushed by child #1 during play time, and child #2 sustained a nose injury. Child #2 was then taken to the hospital by their legal guardian.

During this inspection, LPA Tamayo interviewed child #2 and the staff involved in the incident. However, LPA Tamayo was unable to interview child #1, as the child was not present at the time of the inspection. According to the interviews, both children were playing outside near the sand and cement area. The children were taking turns going up and down the stairs when child #1 accidentally ran into child #2. Child #1 was unable to maintain their balance and, as a result, unintentionally pushed child #2, causing them to fall and hit their nose on the sidewalk.

After the fall, staff immediately took child #2 inside, where Teacher #1 applied an ice pack to the child's nose to stop the bleeding. The Director promptly notified the parents. According to the Director, child #2 has been placed on play restrictions to allow their nose to heal properly. The incident was determined to be accidental, and staff responded quickly, providing the necessary first aid to child #2.

Please see LIC809-C for Continuation Page.

SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Justeene Tamayo
LICENSING EVALUATOR SIGNATURE: DATE: 11/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/22/2024
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		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 CENTER
FACILITY NUMBER: 364819502
VISIT DATE: 11/22/2024
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According to the Director, she followed up with the guardian of child #2 on 11/22/24. Child #2 is currently back at the facility and is awaiting a follow-up doctors appointment. Once the follow-up visit is completed, the Director will send LPA Tamayo the finalized physician's report.

No deficiencies will be cited at this time. The facility took appropriate measures to ensure child #2 obtained necessary first aid in a timely manner, and parents were notified immediately of the incident.

An exit interview was conducted, and a copy of this report was read and provided to the Director, along with a copy of her appeal rights and Notice of Site Visit.
SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Justeene Tamayo
LICENSING EVALUATOR SIGNATURE:

DATE: 11/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/22/2024
LIC809 (FAS) - (06/04)
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