<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 153801077
Report Date: 05/16/2024
Date Signed: 05/17/2024 07:49:51 AM

Document Has Been Signed on 05/17/2024 07:49 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 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: 46DATE:
05/16/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:30 AM
MET WITH:Madisann Parks TIME VISIT/
INSPECTION COMPLETED:
02:45 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 05/16/2024 , Licensing Program Analyst (LPA) Beneroso conducted an unannounced Case Management Incident inspection and met with director, Madisann Park. LPA disclosed the purpose of the inspection and was granted entry into the facility by the director. There were 46 children and 17 staff present in the facility during the inspection. The purpose of the inspection was to follow up on a self-reported unusual incident report (UIR) which occurred on March 15, 2024 at the facility.

Description of incident: The incident took place on 03/15/24 at the childcare center involving Child#1 (C1). Child #1 had a seizure in the bathroom of the facility. On the day of the incident, C1 woke up from naptime and was taken to the bathroom as they usually do after a nap with the assistance of Staff #1 (S1). Once inside the bathroom, S1 noticed the child sitting down on the floor then laying down. S1 noticed C1’s eyes twitching and immediately alerted S2 who instructed S3 to call 911. S3 called 911 and S2 assisted the child until paramedics arrived. Per staff members, paramedics showed up within a few minutes. Once paramedics arrived took the child into their care, transporting C1 to a nearby hospital. C1 returned to school a few days after the incident and no further instructions were giving by C1’s doctor. Interview with C1’s father (P1) disclosed that he was satisfied with the way the facility handled the situation.

Based on information obtained and interviews with S1, S2, and S3 and P1 via phone it is determined that staff properly rendered aid to child in a timely manner.

It was determined the incident does not appear to have been the result of any violation of the Title 22 regulations, therefore, no deficiencies were cited.



An exit interview was conducted and a copy of the report was read and provided to the director, Madisann Parks.
SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Barbara Beneroso
LICENSING EVALUATOR SIGNATURE: DATE: 05/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/16/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 1