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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197492945
Report Date: 03/03/2022
Date Signed: 03/04/2022 09:49:08 AM


Document Has Been Signed on 03/04/2022 09:49 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:KIDS TOWN CHILDCARE CENTER, LLCFACILITY NUMBER:
197492945
ADMINISTRATOR:ANA GARCIAFACILITY TYPE:
840
ADDRESS:1825 WEST AVENUE J, SUITE 125TELEPHONE:
(661) 951-2070
CITY:LANCASTERSTATE: CAZIP CODE:
93534
CAPACITY:45CENSUS: 24DATE:
03/03/2022
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
12:45 PM
MET WITH:Ana Garcia, DirectorTIME COMPLETED:
06:00 PM
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Licensing Program Analyst's (LPA) Donna Maddox and Brigitte Tsutaoka conducted an unannounced Case Management - Incident inspection regarding the self disclosed incident where a child claimed he was pushed up against the fence by the Director. LPA's disclosed the purpose of the inspection and were granted entry by Director, Ana Garcia. Upon entry, LPA's noted 1 School age child in care, by the end of this investigation, there were 24 School age children.

During this inspection, LPA's interviewed children who were sitting at the table at the time of the incident. On 3/1/2022, The Director states she observed that child #1 had taken the laces from his shoes and was chewing on them and began throwing his shoes up in the air. Director stated she approached child #1 (with her hands crossed behind her back) and leaned down and asked him to stop chewing on his shoe laces and to stop throwing his shoes in the air before he hurts someone. The Director stated, as she was talking to child #1 he leaned back against the fence, the sister of child #1 observed the incident from across the play yard and accused the Director of pushing him (child #1). LPA interviewed the alleged victim today (child #1) who denied the incident happened, he stated he didn't remember anything about that day except that he was playing with his shoes.

Based on information gathered during the investigation, it does not appear a violation of Title 22 Regulations occurred. An exit interview was conducted, a copy of this Report, Appeal Rights, and Notice of Site Visit were provided to Ms. Ana, Director.
SUPERVISOR'S NAME: Mariela RamonTELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Donna MaddoxTELEPHONE: (661) 568-8971
LICENSING EVALUATOR SIGNATURE:
DATE: 03/03/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/03/2022
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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