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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197415948
Report Date: 10/10/2023
Date Signed: 10/10/2023 10:40:54 AM


Document Has Been Signed on 10/10/2023 10:40 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
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551



FACILITY NAME:BOGGS FAMILY CHILD CAREFACILITY NUMBER:
197415948
ADMINISTRATOR:BOGGS, KRISTINAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(661) 802-4420
CITY:LANCASTERSTATE: CAZIP CODE:
93536
CAPACITY:14CENSUS: 10DATE:
10/10/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
09:01 AM
MET WITH:Kristina BoggsTIME COMPLETED:
09:32 AM
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On 10/10/23, Licensing Program Analyst (LPA) Carol Heath met with licensee Kristina Boggs, who guided LPA on a tour of the facility. The purpose of this visit was to conduct a Case Management - Incident inspection. This Unusual Incident was self reported for the incident that happened on 9/27/2023. Upon arrival, LPA observed 9 preschool children and 1 infant in care, along with assistant #1 and the licensee.

Description of incident: On 9/23/23, child #1 was running in the backyard, fell, and cut his hand. The parents took him to urgent care, where he got stitches and returned to Daycare the next day.

At the time of inspection, LPA interviewed the assistant present on 9/23/23,child#1 , and the licensee.

After interviewed all related parties, it was revealed child #1's injury was accident due to inappropriate shoes.

The facility is found to be in compliance with Title 22 Regulations, and no deficiencies are being cited at this time.

An exit interview was conducted and a copy of this report was provided to the licensee,Kristina Boggs.

SUPERVISOR'S NAME: Claretta YatesTELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Carol HeathTELEPHONE: (661) 202-3709
LICENSING EVALUATOR SIGNATURE:
DATE: 10/10/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/10/2023
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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