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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 153801077
Report Date: 10/16/2024
Date Signed: 10/16/2024 03:01:15 PM

Document Has Been Signed on 10/16/2024 03:01 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:		PARKS, MADISANNFACILITY TYPE:
850
ADDRESS:329 S. MILL ST.TELEPHONE:
(661) 823-7740
CITY:TEHACHAPISTATE: CAZIP CODE:
93561
CAPACITY: 64TOTAL ENROLLED CHILDREN: 64CENSUS: 40DATE:
10/16/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:36 AM
MET WITH:Madisann ParksTIME VISIT/
INSPECTION COMPLETED:
03:05 PM
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On 10.16.24, Licensing Program Analyst (LPA) Kris Diaz conducted an unannounced Case Management Inspection at the facility. LPA was greeted and granted access to the facility by the Facility Director, Madisann Parks. The purpose of the visit was to follow up on a UIR received at Palmdale RO on 10.9.24. Upon arrival LPA conducted a safety inspection in which LPA Diaz observed zero deficiencies. LPA observed 40 children in care with 7 staff. LPA also observed 7 infants with 2 staff.

During the visit, LPA conducted staff interviews with 4 staff (S1-S4). Children involved in the incident were 4 years old and younger so no interviews were conducted with them. LPA issued a Technical Violation for reporting requirements. The UIR was received by Palmdale RO on 10.9.24 and LPA confirmed that the incident occurred on 10.7.24. LPA reminded facility representative that staff are required to report incidents to the RO within 24 hours by contacting the On-duty officer. No deficiencies were issued during this visit. At this time further investigation is needed.

This inspection was conducted in person. A copy of this report was read and left with Facility Director, Madisann Parks. A Notice of Site Visit was provided and must be posted for 30 days. Exit interview conducted.
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Kristina Diaz
LICENSING EVALUATOR SIGNATURE: DATE: 10/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/16/2024
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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