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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 367750020
Report Date: 10/09/2024
Date Signed: 10/09/2024 11:36:55 AM

Document Has Been Signed on 10/09/2024 11:36 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:JUST 4 TODDLERS PRESCHOOLFACILITY NUMBER:
367750020
ADMINISTRATOR/
DIRECTOR:		MEZA, LINDAFACILITY TYPE:
830
ADDRESS:15400 RANCHERO ROADTELEPHONE:
(760) 244-4600
CITY:HESPERIASTATE: CAZIP CODE:
92345
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 3DATE:
10/09/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:00 AM
MET WITH:VP of Operation, Breesa Inman TIME VISIT/
INSPECTION COMPLETED:
11:45 AM
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Licensing Program Analyst (LPA) Carol Heath conducted a case management incident inspection with VP of Operation, Breesa Inman regarding a Unusual Incident Report (UIR) received by phone on 10/01/2024. During the visit, LPA toured the facility and conducted a headcount of the children. At the time of arrival, 3 infants were present, along with 2 teachers, the VP, and the assistant director.

Incident Description:
On 09/27/2024, the Director contacted the PRO Officer of the Day (OD) to report an Unusual Incident Report (UIR). The incident involved Child #1 (DOB: 3/21/23), who was in the infant room engaged in free play when she lost her balance and fell face-first onto the tile floor. As a result, Child #1 developed a bump on her forehead.

LPA reviewed child #1’s file, received facility roster and interviewed the infant teacher. In addition, LPA received pictures of child#1 and

After reviewing the information and conducting interview, it was determined that the incident was not due to violating Title 22 regulations; no deficiencies were cited.

An exit interview was conducted, and a copy of the report was reviewed and provided to VP of Operation, Breesa Inman.

SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Carol Heath
LICENSING EVALUATOR SIGNATURE: DATE: 10/09/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/09/2024
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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