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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197419296
Report Date: 01/22/2020
Date Signed: 01/22/2020 04:26:07 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1605 EAST PALMDALE BLV, STE A
PALMDALE, CA 93550
FACILITY NAME:TUTOR TIME CHILD CARE LEARNING CENTERSFACILITY NUMBER:
197419296
ADMINISTRATOR:SERRANO, ANGIEFACILITY TYPE:
830
ADDRESS:23041 NEWHALL RANCH ROADTELEPHONE:
(661) 263-2655
CITY:SANTA CLARITASTATE: CAZIP CODE:
91350
CAPACITY:30CENSUS: 7DATE:
01/22/2020
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
02:30 PM
MET WITH:Angie SerranoTIME COMPLETED:
04:30 PM
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Licensing Program Analyst (LPA) Ortega met with Director, Angie Serrano and conducted a Case Management inspection on an Unusual Incident reported to Licensing on December 5, 2019. This incident was self -reported.

Description of the incident: On December 5, 2019, staff was informed that Child #1 tripped and fell and a red mark developed under the infant's left eye. Per staff, and ice pack was applied and parent was notified immediately.

LPA Ortega interviewed staff and other parties regarding the incident. Staff and child's file were reviewed and roster of children in care was obtained. Based on information provided, adequate supervision was met and infant lost balance and fell.

No deficiencies were cited during this case management inspection.

Notice of site visit was given to be posted for 30 days.
Exit interview was conducted, report was read and a copy was given to the director Angie Serrano.
SUPERVISOR'S NAME: Carissa BellTELEPHONE: (661) 202-3359
LICENSING EVALUATOR NAME: Isabel OrtegaTELEPHONE: (661) 202-3786
LICENSING EVALUATOR SIGNATURE:

DATE: 01/22/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/22/2020
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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