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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197492943
Report Date: 03/23/2022
Date Signed: 03/23/2022 05:29:05 PM


Document Has Been Signed on 03/23/2022 05:29 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
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551



FACILITY NAME:KIDS TOWN CHILDCARE CENTER, LLCFACILITY NUMBER:
197492943
ADMINISTRATOR:ANA GARCIAFACILITY TYPE:
830
ADDRESS:1825 WEST AVENUE J, SUITE 125TELEPHONE:
(661) 951-2070
CITY:LANCASTERSTATE: CAZIP CODE:
93534
CAPACITY:30CENSUS: 5DATE:
03/23/2022
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
01:55 PM
MET WITH:Director, Ana GarciaTIME COMPLETED:
03:59 PM
NARRATIVE
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Licensing Program Analyst's (LPA's) Maddox and Tsutaoka met with Director, Ana Garcia today to conduct an unannounced, Case Management inspection. During this inspection there were 5 Infants present with 2 Staff (1 infant was asleep in a separate area, without direct supervision, and sleeping on his stomach). LPA reminded the Director of the new Safe Sleep regulations and requested Staff turn the Infant onto his back immediately. Also, while conducting the walk through of the center, LPA's inspected the fire extinguisher in the Infant Room and noted the last service was performed December 2019. LPA's toured the remainder of the center and noted there are 5 fire extinguishers throughout the center and all tags indicate the last service was preformed 12/2019. Since there are no fire extinguishers in the entire center with recent or current service dates and no sprinklers system observed, this creates an immediate Health and Safety risk to children in care, a Type A citation was issued under Section 101238(a) Building and Grounds and and Section 101429 Infant Responsibility for Providing Care and Supervision for Infant.
SUPERVISOR'S NAME: Mariela RamonTELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Donna MaddoxTELEPHONE: (661) 568-8971
LICENSING EVALUATOR SIGNATURE:
DATE: 03/23/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/23/2022
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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Document Has Been Signed on 03/23/2022 05:29 PM - It Cannot Be Edited

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: KIDS TOWN CHILDCARE CENTER, LLC
FACILITY NUMBER: 197492943

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/23/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
03/25/2022
Section Cited

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Buildings and Grounds
(a) The child care center shall be clean, safe, sanitary and in good repair at all times to ensure the safety and well-being of children, employees and visitors.
Type A
03/25/2022
Section Cited

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(B)(3)(a)Each infant shall be constantly supervised and under direct visual observation and supervision by a staff person at all times. Infants up to 12 months of age who are sleeping in a position other than
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on their back. a. If the infant’s Individual Infant Sleeping Plan [LIC 9227 (3/20)] does not have Section C completed, staff shall return the infant to their back for sleeping. This requirement was not met as evidenced by: LPA observed an Infant alone in a crib located in the rear of the Infant Center, LPA's also observed the Infant asleep on his tummy.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Mariela RamonTELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Donna MaddoxTELEPHONE: (661) 568-8971
LICENSING EVALUATOR SIGNATURE:
DATE: 03/23/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/23/2022
LIC809 (FAS) - (06/04)
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