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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 153801077
Report Date: 05/07/2024
Date Signed: 05/07/2024 12:20:13 PM

Document Has Been Signed on 05/07/2024 12:20 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:GOOD SHEPHERD PRESCHOOL & CHILD CARE CENTERFACILITY NUMBER:
153801077
ADMINISTRATOR/
DIRECTOR:		ARNECKE, KRISTENFACILITY TYPE:
850
ADDRESS:329 S. MILL ST.TELEPHONE:
(661) 823-7740
CITY:TEHACHAPISTATE: CAZIP CODE:
93561
CAPACITY: 64TOTAL ENROLLED CHILDREN: 64CENSUS: 38DATE:
05/07/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:45 AM
MET WITH:Madisann Park TIME VISIT/
INSPECTION COMPLETED:
12:30 PM
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On 05/07/24, Licensing Program Analyst (LPA) Beneroso met with director, Madisann Parks to conduct an unannounced case management inspection. The purpose of the case management is to follow up on unusual incident report (UIR) received 3/15/24. Incident occurred on 3/15/24, C1 had a seizure at approximately 2:30PM. Child 1 required medical assistance and an ambulance transported C1 to the hospital. Child has since been released from hospital. The child has returned to the facility approximately a week after the incident.

Upon arrival, LPA observed 38 daycare children and 9 staff member providing care.

During this inspection LPA conducted interview with Director in private. In addition, during the inspection, LPA obtained copies of facility roster.

Due to the need to gather additional information, this case management will require further investigation.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted with directo, Madisann Parks.

SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Barbara Beneroso
LICENSING EVALUATOR SIGNATURE: DATE: 05/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/07/2024
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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