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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 367750031
Report Date: 02/25/2025
Date Signed: 02/25/2025 10:10:16 AM

Document Has Been Signed on 02/25/2025 10:10 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
PALMDALE CC RO, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME:KIDS & CARE INC.FACILITY NUMBER:
367750031
ADMINISTRATOR/
DIRECTOR:		PATRICIA JACOBSFACILITY TYPE:
850
ADDRESS:10522 MANHASSET ROADTELEPHONE:
(760) 956-5000
CITY:APPLE VALLEYSTATE: CAZIP CODE:
92308
CAPACITY: 30TOTAL ENROLLED CHILDREN: 30CENSUS: 9DATE:
02/25/2025
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:30 AM
MET WITH:Patricia Jacobs- Director TIME VISIT/
INSPECTION COMPLETED:
10:30 AM
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On Tuesday, February 25, 2025 Licensing Program Analyst (LPA) Braddock met with Director PATRICIA JACOBS for the purpose of following up on an unusual incident report submitted to Palmdale Regional Office (PRO) on 02/04/2025. During the visit, LPA toured the facility and took a census of the children present. LPA observed 9 children with 1 teacher providing care and supervision.

The incident report indicated two children were fighting on the van during pick up.

During this investigation, LPA interviewed director, parents and requested relevant documents. Based on information provided and interviews conducted, it was determined NO further investigation is needed.

Exit interview was conducted, and a copy of this report was read and provided to the Director. The notice of sight visit must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days.
SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Sherell Braddock
LICENSING EVALUATOR SIGNATURE: DATE: 02/25/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/25/2025
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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