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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 367750029
Report Date: 10/28/2022
Date Signed: 10/28/2022 11:03:06 AM

Document Has Been Signed on 10/28/2022 11:03 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 & CARE, INC.FACILITY NUMBER:
367750029
ADMINISTRATOR:CLAUDIA V. GARCIAFACILITY TYPE:
830
ADDRESS:10522 MANHASSET ROADTELEPHONE:
(760) 956-5000
CITY:APPLE VALLEYSTATE: CAZIP CODE:
92308
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: DATE:
10/28/2022
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
10:43 AM
MET WITH:Patricia JacobsTIME COMPLETED:
11:20 AM
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On October 28, 2022, Licensing Program Analyst (LPA) Babatunde Ibitoye made an unannounced visit to the above facility to deliver findings for the Unusual Incident received on 10/08/2022. LPA met with Patricia Jacobs. During today’s inspection, there are (8) day-care children present with (4) staff members.

An unusual incident report was received on 10/08/2022 reporting that a Law Enforcement Officer, arrived at the facility to investigate an incident that occurred on 10/06/22 involving C#1 who was alleged of sustaining an injury while in care.

Based on the investigation, interviews and evidence obtained, from the Department’s Investigation Branch it was determined that C#1 did not sustain the injury while in care at the Child Care Center.

No deficiencies were cited.

An exit interview was conducted:

This report, Appeal Rights and Notice of Site Visit was discussed, and a copy of the report was provided to the facility Director Patricia Jacobs.

SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Babatunde Ibitoye
LICENSING EVALUATOR SIGNATURE: DATE: 10/28/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/28/2022
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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