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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197405989
Report Date: 06/09/2021
Date Signed: 06/09/2021 01:38:47 PM

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:JUST PLANE KIDSFACILITY NUMBER:
197405989
ADMINISTRATOR:KAUR, KAMALJITFACILITY TYPE:
840
ADDRESS:2555 E. AVENUE PTELEPHONE:
(661) 267-1304
CITY:PALMDALESTATE: CAZIP CODE:
93550
CAPACITY:28CENSUS: 16DATE:
06/09/2021
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
10:54 AM
MET WITH:Jackie Strickland and Kamaljit Kaur TIME COMPLETED:
01:50 PM
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On June 9, 2021 at 10:54AM, Licensing Program Analyst (LPA) Tsutaoka conducted an unannounced Case Management - Incident inspection. LPA disclosed the purpose of the inspection and was granted entry by Office Manager Jackie. Upon entry, LPA counted 16 school aged children in care with 2 teachers in separate classrooms. At 11:30AM, Director Kamaljit Kaur arrived and took LPA on a guided tour of the facility.

During inspection, LPA conducted interviews with staff, children, and reviewed the video of the incident. LPA also inspected the area where Child 1 fell. LPA felt shelving unit where Child 1 hit and observed smooth edges and the furniture in good repair. According to Director, a rug was on the floor during incident, but was removed as a safety precaution even though it was not the cause of the fall. LPA observed the video footage and witnessed Child 1 get up from her seat, run to the "parent pocket," trip over her shoe as it slipped off her foot, and fall forward onto the shelf. The "Parent Pocket" is the term coined by the facility identifying the area children submit their classwork. LPA observed Child 1's shoe come off her foot and the carpet stand still. Based on interviews conducted, it was determined Child 1 was wearing Crocs. Director stated she has implemented a new policy altering the dress code to exclude open toed shoes and address the necessity of "walking feet" inside the classroom with all children daily.

Based on evidence obtained and interviews conducted, no deficiencies were noted and no citations will be issued today. An exit Interview was conducted, a copy of this Report, Appeal rights and a Notice of Site visit was provided to the Director.
SUPERVISOR'S NAME: Carissa BellTELEPHONE: (661) 202-3359
LICENSING EVALUATOR NAME: Brigitte TsutaokaTELEPHONE: (661) 202-3786
LICENSING EVALUATOR SIGNATURE:

DATE: 06/09/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/09/2021
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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