150407506-3-9-2022-12-CC-EROZ-CCCV3T-20220309150512

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 150407506
Report Date: 03/09/2022
Date Signed: 03/09/2022 03:05:26 PM

Document Has Been Signed on 03/09/2022 03:05 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:	TEHACHAPI CHILD DEVELOPMENT CENTER		FACILITY NUMBER:	150407506
ADMINISTRATOR:	KIMBERLY D FREIBERG		FACILITY TYPE:	850
ADDRESS:	1120 S. CURRY ST.		TELEPHONE:	(661) 822-5535
CITY:	TEHACHAPI	STATE: CA	ZIP CODE:	93561
CAPACITY:	27	CENSUS: 22	DATE:	03/09/2022
TYPE OF VISIT:	Case Management - Other	UNANNOUNCED	TIME BEGAN:	11:15 AM
MET WITH:	Kimberly D. Freiberg		TIME COMPLETED:	01:30 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	On 03/09/20 at 11:15 p.m. Licensing Program Analysts (LPA) Esequiel Rodriguez conducted an unannounced Case Management inspection at the Tehachapi Child Development Center for the purpose of following up and see how they are doing on their current operation of Center's program, and physical plant status. Also, to provide technical assistance as deem necessary in order for Center to continue to meet compliance with California Code of Regulations (CCR) Title 22, Health and Safety requirements, and other applicable State and Licensing Statutory requirements. And to follow up with the Licensee regarding the importance of being familiarized with the Community Care Licensing Division's (CCLD) inspection tools, known as the Compliance and Regulatory Enforcement (CARE) Tools that were developed under the Department's (IPP) Inspection Process Project. The LPA met with the Facility Administrator, Kimberly Freiberg and stated the purpose for the inspection as stated above. The facility license is posted on a prominent place of the Center. Currently there are 22 children in the program. The Administrator provided copy of the Child Care Center children rosters for each classroom (LIC 9040), and Personnel Report (LIC 500). LPA explained that the CARE Tools are now used by Licensing Program Analysts (LPAs) when conducting inspections in licensed facilities. The CARE Tools focus CCLD’s efforts in the three IPP priority areas: Prevention, Compliance and Enforcement. The CARE Tools for Child Care Centers evaluates, but not limited to, the following licensing domains: • Care and Supervision: Protecting children in care; monitoring food intake or special diets; assistance in diapering, toileting, dressing, and other personal

SUPERVISOR'S NAME: Scott Herring	TELEPHONE: (661) 202-3314
LICENSING EVALUATOR NAME: Esequiel Rodriguez	TELEPHONE: (661) 202-3321
LICENSING EVALUATOR SIGNATURE:	DATE: 03/09/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/09/2022

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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION 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: TEHACHAPI CHILD DEVELOPMENT CENTER	FACILITY NUMBER: 150407506
	VISIT DATE: 03/09/2022

NARRATIVE

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hygiene needs; taking medication; etc.

• Children's Records: Documentation on special diet or medical needs,
immunization's, individual development plans, etc.

• Food service: Food and beverages provided to children in care.

• Personal Rights: Children's personal rights.

• Physical Plant: Furniture, toys, flooring, cleanliness, etc.

• Reporting Requirements: Reporting incidents, etc.

• Staff Records: Staff experience, qualifications, criminal record clearances and
exemptions, training, general information applicable to staff, etc.

• Staffing Ratio and Capacity: Staffing ratios per number of children in care.

• Toddler Component: Children 18 months to three years of age (as applicable).

The LPA encouraged licensee to become familiar with the Guardian Background Check Program and CARE Tools inspection processes by periodically visiting the Child Care Program (CCP) section of the CCLD Inspection Process Project Website at www.ccl.ca.gov and
https://www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process
The page is updated regularly and contains the new tools and related documents that can be downloaded. Ms. Freiberg acknowledged.

The LPA provided a copy of LIC 9118, Facility Inspection Checklist and LIC 125, Entrance Checklist and explain that the Facility shall review these forms to ensure the Child Care Center's file is current and up-to-date. Ms. Freiberg acknowledged. Although, the LIC 9040, Child Care Facility Roster and LIC 500, Personnel

SUPERVISOR'S NAME: Scott Herring	TELEPHONE: (661) 202-3314
LICENSING EVALUATOR NAME: Esequiel Rodriguez	TELEPHONE: (661) 202-3321
LICENSING EVALUATOR SIGNATURE:	DATE: 03/09/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/09/2022

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
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: TEHACHAPI CHILD DEVELOPMENT CENTER	FACILITY NUMBER: 150407506
	VISIT DATE: 03/09/2022

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Report, and LIC 311A are not listed on the LIC 125, these forms shall be maintained up-to-date and available.

At 12:29 p.m., LPA Rodriguez along with Administrator, conducted an overall visual assessment of the inside and outside the Center's physical plant. The Center is clean, safe, sanitary and well maintain. All utilities are operational and in good order. There is plenty parking space. The first aid kit is present and complete and is inaccessible to children/infants. The fire extinguishers, smoke alarms and carbon monoxide monitors are in compliance and fully operational. The Center conducts and records emergency disaster drills.

The LPA advise Ms. Freiberg to ensure the parent board contains the following: PUB 269, Child Passenger Restraint System poster; PUB 393, Notification of Parent's Rights; LIC 610, Emergency Disaster Plan, LIC 9148, Earthquake Preparedness form; LIC 613A, Personal Rights, and is posted in an area accessible to parents.

LPA advise Licensee to ensure every one working at the center is current in all required training and properly qualified to provide quality care and safe supervision to children in care. Also to have their Plan of Operation and Parent Handbook available.

During today's inspection the LPA observed no deficiencies that may hinder the health and safety of the children in care. Therefore, no deficiencies were cited.

An exit Interview was conducted and a copy of this Report and notice of site visit (LIC 9213) was provided to the Administrator.

SUPERVISOR'S NAME: Scott Herring	TELEPHONE: (661) 202-3314
LICENSING EVALUATOR NAME: Esequiel Rodriguez	TELEPHONE: (661) 202-3321
LICENSING EVALUATOR SIGNATURE:	DATE: 03/09/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/09/2022

LIC809 (FAS) - (06/04)

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