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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364844285
Report Date: 08/26/2021
Date Signed: 08/26/2021 03:33:08 PM

Document Has Been Signed on 08/26/2021 03:33 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:KIDCARE CHILD DEVELOPMENT CENTERFACILITY NUMBER:
364844285
ADMINISTRATOR:CARMEN RODRIGUEZFACILITY TYPE:
830
ADDRESS:15025 GRAVILLA RDTELEPHONE:
(760) 955-6466
CITY:VICTORVILLESTATE: CAZIP CODE:
92392
CAPACITY: 8TOTAL ENROLLED CHILDREN: 0CENSUS: 2DATE:
08/26/2021
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
03:00 PM
MET WITH:Carmen RodriguezTIME COMPLETED:
03:47 PM
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On 08/26/21 Licensing Program Analysts (LPA's) Dorsey and Ibitoye conducted an Inspection at KidCare Child Development Center. The purpose of the inspection was a Plan of Correction to review the deficiencies cited on 08/17/21. LPA Dorsey met with Director Carmen Rodriguez and toured the facility.

The following was observed:
1.) LPA Dorsey observed the blankets in the infants cribs had been removed. Per Director the blankets were returned to the parents.
2.) LPA Dorsey observed the facility had a documented disaster drill on 08/18/21

Exit interview conducted a copy of this report, Notice of Site Inspection and Deficiency Clearance Letter was left with the Director Carmen Rodriguez..
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Justin Dorsey
LICENSING EVALUATOR SIGNATURE: DATE: 08/26/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/26/2021
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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