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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 367750034
Report Date: 09/29/2023
Date Signed: 09/29/2023 02:38:59 PM

Document Has Been Signed on 09/29/2023 02:38 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
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME:KIDS & CARE INC.FACILITY NUMBER:
367750034
ADMINISTRATOR:CLAUDIA V. GARCIAFACILITY TYPE:
850
ADDRESS:15138 MAIN ST.TELEPHONE:
(760) 956-5000
CITY:HESPERIASTATE: CAZIP CODE:
92345
CAPACITY: 12TOTAL ENROLLED CHILDREN: 12CENSUS: 12DATE:
09/29/2023
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
01:40 PM
MET WITH:Sonia Galvaz, Assistant Director TIME COMPLETED:
02:30 PM
NARRATIVE
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On September 29, 2023, Licensing Program Analyst (LPA) Calloway made an unannounced inspection at the above facility. LPA met with the Assistant Director (S1) who granted access. LPA toured the facility with S1.

LPA did not observe the Type A report and 809 D page that were issued 9/28/23, posted as required on the facility parent wall for parents to view. Per Assistant Director, only the LIC 9224 went out on the parent portal app for the parents. The parents have not signed the form to go into the children's files.

Per Title 22 Regulations, there is a Type A deficiency cited during this inspection for: 1596.8596(a)(1)(3) H&SC for not posting the Type A report upon receipt and deficiency page on the wall for the parents to view. During the inspection, there is $100 Immediate Civil Penalty assessed for failure to post the Type A violation for thirty (30) consecutive days.

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.
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Kuliema Calloway
LICENSING EVALUATOR SIGNATURE: DATE: 09/29/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/29/2023
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 09/29/2023 02:38 PM - It Cannot Be Edited


Created By: Kuliema Calloway On 09/29/2023 at 01:51 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: 367750034

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/29/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
09/30/2023
Section Cited
HSC
1596.8595(a)(1)(3)

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1596.8595(a)(1)(3):(a)(1) Posting licensing report by child care facility ...civil penalty for failure to comply reports to be provided to parents..(3) Failure to comply with paragraph (1) shall result in an immediate civil penalty of one hundred dollars ($100). This requirement was not met as evidenced by:
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Per Assistant Director, the notices will be posted immediately and a copy of the Type A report immediately, and send in the portal app to parents, and give a copy of the report and parents sign the Acknowledgement of receipt form.

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Based on observation and interview upon arrival LPA did not observe the posted Type A deficiency report 809 and 809D page on the parent window, wall, or board for parents to view. Per Assistant Director, the parents were notified with LIC 9224 on parent portal app. form has not been signed as of yet.
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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:Claretta Yates
LICENSING EVALUATOR NAME:Kuliema Calloway
LICENSING EVALUATOR SIGNATURE:
DATE: 09/29/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/29/2023


LIC809 (FAS) - (06/04)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: KIDS & CARE INC.
FACILITY NUMBER: 367750034
VISIT DATE: 09/29/2023
NARRATIVE
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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 (LIC 9224) 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 was conducted a copy of this report was read, discussed, and provided to Sonia Galvaz, Assistant Director, along with a Notice of Site Visit, and Appeal Rights. The Notice of Site Visit must remain posted for thirty (30) consecutive days, failure to maintain posting will result in a $100 Civil Penalty per day.

SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Kuliema Calloway
LICENSING EVALUATOR SIGNATURE:

DATE: 09/29/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/29/2023
LIC809 (FAS) - (06/04)
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