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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197492945
Report Date: 03/23/2022
Date Signed: 03/23/2022 05:14:06 PM


Document Has Been Signed on 03/23/2022 05:14 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:
197492945
ADMINISTRATOR:ANA GARCIAFACILITY TYPE:
840
ADDRESS:1825 WEST AVENUE J, SUITE 125TELEPHONE:
(661) 951-2070
CITY:LANCASTERSTATE: CAZIP CODE:
93534
CAPACITY:45CENSUS: 21DATE:
03/23/2022
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
01:55 PM
MET WITH:Ana GarciaTIME COMPLETED:
05:20 PM
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On March 23, 2022 at 1:55PM, Licensing Program Analysts (LPAs) Brigitte Tsutaoka and Donna Maddox conducted a follow up inspection to confirm the correction for citation issued on complaint 12-CC-20220225081115 regarding van in disrepair was corrected by due date of 03/18/2022. LPAs disclosed the purpose of inspection and were granted entry by Director, Ana Garcia. During inspection, LPAs observed 21 children with 2 staff (confirmed on association list).

During inspection, Facility staff disclosed the facility van was not at the center. Assistant Director (AD) stated the owner has a technician who comes to service the vans, but he was unable to come service the vans at this time. AD decided to make the appointment to take the van this coming weekend of 3/26/2022 to have the tail light repaired. Director confirmed the appointment for the van to be repaired is 3/26/2022.

Based on evidence obtained and interviews conducted, the facility has failed to correct the deficiency by the plan of correction deadline and civil penalties of $500 were assessed.

An exit interview was conducted, this Report, Appeal Rights, and Notice of Site visit were provided to director, Ana Garcia.
SUPERVISOR'S NAME: Carissa BellTELEPHONE: (661) 202-3359
LICENSING EVALUATOR NAME: Brigitte TsutaokaTELEPHONE: (661) 202-3786
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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