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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 367750029
Report Date: 09/22/2023
Date Signed: 09/22/2023 05:36:52 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
This is an official report of an unannounced visit/investigation of a complaint received in our office on
09/18/2023 and conducted by Evaluator Justeene Tamayo
PUBLIC
COMPLAINT CONTROL NUMBER: 12-CC-20230918154211
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:8CENSUS: 11DATE:
09/22/2023
UNANNOUNCEDTIME BEGAN:
12:43 PM
MET WITH:Patricia Jacobs, Director TIME COMPLETED:
05:45 PM
ALLEGATION(S):
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Allegations:
-License-Licensee is operating beyond the terms of the license

INVESTIGATION FINDINGS:
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 On 09/22/2023 Licensing Program Analysts(LPAs) Justeene Tamayo and Andrew Alemoh conducted an initial 10 day complaint investigation related to the allegations above. LPAs disclosed the purpose of the investigation and was granted entry into the facility by Director Patricia Jacobs. A tour of the facility was conducted, a total of 1 classroom was toured. LPAs verified a census of 11 infants and total of 2 Staff, along with the Director.

During today's investigation, LPA obtained a copy of sign out sheets, and other supportive documentation. LPAs als interviewed children and staff involved.

Allegation #1: During initial walk through, LPAs observed a census of 11 infants to two teachers. The facility is operating beyond the limitation specified on the Facility License of 8 infants, and did not meet Title 22 Regulations, which poses an immediate health and safety risk to children in care.

Please see LIC9099-C for continuation page.

Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Justeene Tamayo
LICENSING EVALUATOR SIGNATURE:

DATE: 09/22/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/22/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 3
Control Number 12-CC-20230918154211
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION 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 & CARE, INC.
FACILITY NUMBER: 367750029
VISIT DATE: 09/22/2023
NARRATIVE
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Facility has been cited a Type A Citation-Please see Limitations on Capacity and Ambulatory Status 101161(a) 9099-D for deficiency page. An immediate civil penalty of $1000 has been assessed for repeat violation.

Upon receipt of a Type A deficiency licensee shall post the report for 30 days in addition to the Notice of Site Visit and provide copies of the licensing report to parents/guardians of children in care at the facility. This report must be provided to parents/guardians of children newly enrolled at the facility during the next 12 months and licensee will obtain a signed acknowledgment of Licensing Reports (LIC9224) from parent/guardian and place it in each child's file. If these requirements are not met, civil penalties will be assessed.

An exit interview has been conducted, and a copy of this report was read and provided to Director, along with her Notice of Site visit and Appeal Rights.
SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Justeene Tamayo
LICENSING EVALUATOR SIGNATURE:

DATE: 09/22/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/22/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 12-CC-20230918154211
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION 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 & CARE, INC.
FACILITY NUMBER: 367750029
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/22/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
09/22/2023
Section Cited
CCR
101161(a)
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Limitations on Capacity and Ambulatory Status 101161(a): A licensee shall not operate a child care center beyond the conditions and limitations specified on the license, including the capacity limitation.
This requirement was not met as evidence by:
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Director shall ensure she has a limited capacity of 8 infants.
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LPAs observed 11 infants on the premises with a limited capacity of 8 infants, which poses an immediate health and safety risk to children in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Justeene Tamayo
LICENSING EVALUATOR SIGNATURE:

DATE: 09/22/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/22/2023
LIC9099 (FAS) - (06/04)
Page: 3 of 3