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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197401204
Report Date: 05/20/2021
Date Signed: 05/20/2021 05:27:35 PM

Document Has Been Signed on 05/20/2021 05:27 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:COLLEGE OF THE CANYONS, CHILD DEVELOPMENT CENTERFACILITY NUMBER:
197401204
ADMINISTRATOR:MONICA MARSHALLFACILITY TYPE:
850
ADDRESS:26455 N. ROCKWELL CANYON ROADTELEPHONE:
(661) 362-3513
CITY:VALENCIASTATE: CAZIP CODE:
91355
CAPACITY: 90TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
05/20/2021
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
04:48 PM
MET WITH:Monica MarshallTIME COMPLETED:
05:22 PM
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Licensing Program Analyst (LPA) Thompson-Miller met with Director, Monica Marshall for a Case Management - Incident inspection involving an Incident Report dated May 19, 2021. The incident occurred on May 17, 2021. Inspection conducted virtual due to COVID-19.

Description of the incident: Child #1 left unattended at check in/out station
LPA spoke to Director and toured the check in/out station where Child #1 was left. LPA observed the location where incident occurred and where the Director has relocated the check in/out station.

Based on information provided the incident needs further investigation.

An exit interview was conducted and a copy of this report was read and forwarded to the Director, Monica Marshall via email and mail for confirmation with "Read Receipt" on this date. The Notice of Site Visit was emailed and mailed to Director.
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Linda Thompson-Miller
LICENSING EVALUATOR SIGNATURE: DATE: 05/20/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/20/2021
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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