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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 367750029
Report Date: 10/03/2023
Date Signed: 10/03/2023 02:11:30 PM

Document Has Been Signed on 10/03/2023 02:11 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 & 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: 14DATE:
10/03/2023
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Patricia Jacobs,Licensee TIME COMPLETED:
02:11 PM
NARRATIVE
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On 10/03/2023, Licensing Program Analyst (LPA) Justeene Tamayo met with Director Patricia Jacob's, for the purpose to conduct a Case Management visit-Plan of Correction for the Type A deficiencies that were cited on 09/22/23 and 09/26/23. Upon arrival LPA observed 14 sleeping Infants in care with 3 Teachers. The Center also Licensed for a Preschool component (X367750031) and a School age component (X367750030) on the same premises.

The purpose of the visit is to conduct a Plan Of Correction Visit to ensure the center meets State Licensing Title 22 Regulations: Limitation on Capacity Section 101161(a) and Fire Clearance 101171(a).

A tour of the facility was conducted along with the Director, LPA observed the facility is operating beyond the limitation specified on the Facility License and did not meet the Title 22 Regulations :Limitation on Capacity and the facility is not in compliance with the Fire Clearance granted by the Fire Marshal . A Civil Penalty of $700 has been assessed for failure to correct of limited capacity. See LIC 421FC.

An immediate civil penalty of $500 has been assessed for non-compliance of the Fire Clearance that was granted by the State Fire Marshall. Please see LIC-809-D for deficiency page and LIC 421IM for immediate civil penalty.

An exit interview was conducted, and a copy of this report was read and provided to Director Patricia Jacob's, along with a Notice of Site Visit and appeal rights.
SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Justeene Tamayo
LICENSING EVALUATOR SIGNATURE: DATE: 10/03/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/03/2023
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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Document Has Been Signed on 10/03/2023 02:11 PM - It Cannot Be Edited


Created By: Justeene Tamayo On 10/03/2023 at 01:34 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: KIDS & CARE, INC.
FACILITY NUMBER: 367750029

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/03/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
10/03/2023
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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Informal Conference Meeting has been scheduled
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LPA observed 14 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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Type A
10/03/2023
Section Cited
CCR101171(a)

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Fire Clearance 101171(a): All child care centers shall secure and maintain a fire clearance approved by the city or county fire department, the district providing fire protection services, or the State Fire Marshal.
This requirement was not met as evidence: by:
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Licensee shall ensure she is following the fire clearance granted by the State Fire Marshal.
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LPA observed 14 infants in care, which does not follow the fire clearance granted by the State Fire Marshal, 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.
SUPERVISOR'S NAME:Mariela Ramon
LICENSING EVALUATOR NAME:Justeene Tamayo
LICENSING EVALUATOR SIGNATURE:
DATE: 10/03/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/03/2023


LIC809 (FAS) - (06/04)
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