197417594-1-21-2022-12-CC-LKIG-CAVQYH-20220121113511

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197417594
Report Date: 01/11/2022
Date Signed: 01/21/2022 11:35:33 AM

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:	KAI'S JUSTICE LEARNING ACADEMY		FACILITY NUMBER:	197417594
ADMINISTRATOR:	ADAMS, ALLEA		FACILITY TYPE:	840
ADDRESS:	2739 W. AVENUE L		TELEPHONE:	(661) 718-3614
CITY:	LANCASTER	STATE: CA	ZIP CODE:	93536
CAPACITY:	43	CENSUS:	DATE:	01/11/2022
TYPE OF VISIT:	Office	ANNOUNCED	TIME BEGAN:	01:00 PM
MET WITH:	Allea Adams		TIME COMPLETED:	02:00 PM

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An office meeting was held by Regional Manager (RM) Scott Herring, Licensing Program Manager (LPM) Mariela Ramon, Licensing Program Analyst (LPA) Lady King-Lewis, and Licensee/Administrator Allea Adams via telephone on January 11, 2022.

The purpose of the meeting was to discuss the department concerns regarding a substantiated complaint finding and deficiencies cited; find citations below:

01/18/19, a complaint with the following allegations was substantiated. Personal Rights: Staff 1 picked child 1 up and reposition child 1 inside the classroom. Staff failed to properly redirect child 1. Type B citation issued; Admission Agreements: The facility did not follow the termination agreement stated in the facility parent handbook, which poses a potential Health & Safety risk to children in care. Type B citation issued.

01/10/19, Case Management Inspection. Reporting Requirements: Facility failed to report an unusual incident that occurred on 12-20-18 concerning a staff using force on a child. Type B citation issued.

06/24/21, a complaint with the following allegation was substantiated. Buildings and Grounds: LPA's observed paint chip in the school age room on multiple areas in the

SUPERVISOR'S NAME: Mariela Ramon	TELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Lady King	TELEPHONE: (661) 568-8933
LICENSING EVALUATOR SIGNATURE:	DATE: 01/12/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/12/2022

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
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: KAI'S JUSTICE LEARNING ACADEMY	FACILITY NUMBER: 197417594
	VISIT DATE: 01/11/2022

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room and at the entrance by the front desk.

Licensee stated she has corrected the above concerns, developed a better system for communication, all staff are being trained to prevent these types of violations from reoccurring. Licensee stated the facilities are using Brightwheel to provide better communication with parents and staff.

RM Herring discussed the importance of reporting unusual incidents to the parent and to the Department. Licensee stated she understands the importance of the reporting requirements regulations and will remain in compliance of these requirements.

RM Herring provided information regarding Technical Support Program (TSP), and he explained the program is a non-cost benefit to assist licensees to come into compliance. The TSP consultant assistant is a neutral party that determines some areas of improvement and guides licensees to assist in operating within the bounds of regulations and statutes, developing systems for implementation, and providing best practice suggestions.

Licensee has accepted and has been contacted by TSP. Licensee stated she is looking forward to work with TSP.

An exit interview was conducted. This report was reviewed with the licensee, and a copy of this report was emailed to licensee.

SUPERVISOR'S NAME: Mariela Ramon	TELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Lady King	TELEPHONE: (661) 568-8933
LICENSING EVALUATOR SIGNATURE:	DATE: 01/12/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/12/2022

LIC809 (FAS) - (06/04)

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