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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197403568
Report Date: 04/14/2023
Date Signed: 04/14/2023 12:30:58 PM

Document Has Been Signed on 04/14/2023 12:30 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:KINDERCARE LEARNING CENTERFACILITY NUMBER:
197403568
ADMINISTRATOR:GENESIS BENITEZFACILITY TYPE:
830
ADDRESS:44400 FOXTONTELEPHONE:
(661) 948-1767
CITY:LANCASTERSTATE: CAZIP CODE:
93535
CAPACITY: 24TOTAL ENROLLED CHILDREN: 24CENSUS: 12DATE:
04/14/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:38 AM
MET WITH:Director Ms. GenesisTIME COMPLETED:
12:43 PM
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Licensing Program Analyst (LPA) Maddox met with Director, Ms. Genesis today for the purpose of conducting an unannounced Annual/Random inspection for the Infants and Toddler component. The Hours of Operation: Monday thru Friday from 6:30 AM to 6:30 PM.
**The infant and toddler rooms were equipped with age appropriate furniture and equipment including, but not limited to, cribs, changing tables; and feeding chairs. Telephone service was verified. Heating, lighting, and ventilation are adequate. Children's belongings are kept along the wall as you enter classrooms, cubbies have children's names and pictures. Flooring and carpet were inspected. LPA observed Infant changing tables with padded surface no less than one-inch thick and covered with a washable vinyl or plastic, the sides are at least three inches high, maintained in good repair and safe condition, and within arm's reach of a sink.
*All flooring, carpets, and area rugs were observed to be clean. (Director states carpets are cleaned when necessary). Trash cans/storage containers for solid waste had tight-fitting covers that are kept on, and in good repair
SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Donna Maddox
LICENSING EVALUATOR SIGNATURE: DATE: 04/14/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/14/2023
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
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: KINDERCARE LEARNING CENTER
FACILITY NUMBER: 197403568
VISIT DATE: 04/14/2023
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LPA checked the refrigerator and noted bottles labeled with children's' names, bottles are sent home with parents each day
A sampling of Children's records and staff records were reviewed as part of this inspection. Infant Files contain form LIC 9227, staff also document 15 min checks on Infants.

**Outdoor play equipment was inspected for health, safety, cushioning material, good repair and age appropriateness. Center utilizes rubber matting under climbing structures for cushioning material. Large play equipment and structures are securely anchored. The area was observed to be free of debris.
**There is a Parent Board that contains all required Departmental forms. Sign in and out sheets were inspected an contain full legal signatures. There is a fully stocked first aid kit available and fully charged fire extinguisher. Fire Drill/Earthquake log is posted (last drill conducted 4/6/23.
**Licensee is aware of the requirement to report unusual incidents and/or injuries to the parent/guardian and Licensing within 24 hours of incident by telephone and in writing within 7 day of incident on the form LIC624 per the regulation. The report unusual incident/injuries report should be emailed to UnusualIncidentReport@dss.ca.gov
SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Donna Maddox
LICENSING EVALUATOR SIGNATURE:

DATE: 04/14/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/14/2023
LIC809 (FAS) - (06/04)
Page: 2 of 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: KINDERCARE LEARNING CENTER
FACILITY NUMBER: 197403568
VISIT DATE: 04/14/2023
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**Children are inspected for illnesses as they arrive. A review of medication policy indicated that only prescription medication is administered and only with parent's written permission. The Director/Lead teacher administers the medication and document the dosages, date and time onto a log. The isolation area is located in the director's office. There is a cot available for each ill child.

Incidental Medical Services (IMS) policy was discussed. To provide Incidental Medical Services, such as administering blood glucose monitoring, inhaled medications, Epi-pen and Epi-pen Jr., insulin shots, gastrostomy tube feeding and care, or carrying out other medical orders, it is best practice to complete a “Plan for Providing Incidental Medical Services”. This plan will help you ensure that you can provide this service in the safest manner possible. A Plan for Providing IMS must be submitted to the Department.

**During this inspection facility was observed to be in compliance with Title 22 Regulations. Exit interview conducted and report was reviewed with the licensee a copy of this report and a notice of site visit was given and must remain posted for 30 days.
SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Donna Maddox
LICENSING EVALUATOR SIGNATURE:

DATE: 04/14/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/14/2023
LIC809 (FAS) - (06/04)
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