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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197492945
Report Date: 03/30/2022
Date Signed: 03/30/2022 05:06:33 PM


Document Has Been Signed on 03/30/2022 05:06 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: 24DATE:
03/30/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
10:32 AM
MET WITH:Ana GarciaTIME COMPLETED:
05:15 PM
NARRATIVE
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On March 30, 2022 at 10:32AM, Licensing Program Analysts (LPAs) Brigitte Tsutaoka and Donna Maddox conducted an unannounced Case Management - Other quarterly required inspection. LPAs disclosed the purpose of inspection and were granted entry by Director Ana Garcia. LPAs observed 4 children with 1 staff on association list. At 4:00PM, 24 children and 3 staff on association list were in school age room.

During inspection, LPAs observed the facility under renovations as LPAs required facility to repair physical plant issues. LPAs observed the panels replaced in ceiling, epoxy replaced, and walls painted. LPAs observed the ceiling panels beginning to brown from water damage as a result of the rain. Contractor 1 disclosed the facility roof is damaged and in need of repair. The facility, fire department, and Contractor 1 have been in contact with building owner to repair the roof with no estimated time of completion for the repairs.

LPAs observed the school age room in good repair, but still under renovations. Water is readily available for the children by Aquafina dispenser and water jugs. Children have reusable plastic cups labeled with their names and cleaned after each use. The refrigerator is clean with temperature logs posted on the outside. LPAs observed milk and juice appropriately labeled and within expiration date. The kitchen is clean, organized, and in good repair. The kitchen appliances include an oven/stove top, refrigerator, and freezer. LPAs observed the food labeled, covered, and enough food to last for the week.

LPAs observed the facility restrooms, each with 1 toilet and one sink tested working effectively. Warm water dispenses from both sinks and toilets flush. Hand soap, toilet paper, and paper towels are available for child use. Bathrooms are clean and in good repair.
SUPERVISOR'S NAME: Carissa BellTELEPHONE: (661) 202-3359
LICENSING EVALUATOR NAME: Brigitte TsutaokaTELEPHONE: (661) 202-3786
LICENSING EVALUATOR SIGNATURE:
DATE: 03/30/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/30/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 3


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: 197492945
VISIT DATE: 03/30/2022
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LPAs observed 2A10BC fire extinguishers in green last inspected 3/25/2022. The fire alarm control panel is in good repair. Fire clearance on file. Last disaster drill completed 10/12/2021.

LPAs observed facility sketch, license, menus, personal rights form, Earthquake Preparedness checklist, and Emergency Disaster Plan posted. LPA observed the Earthquake Preparedness Checklist last updated 11/17/2016 with staff appointed to emergency positions of administrative authority who are no longer employed at the facility. California Code of Regulations Title 22 Division 12 Chapter 1 101174
Disaster and Mass Casualty Plan Type B violation was cited. Please see LIC809D for deficiency details.

Due to time constraints, the remainder of this inspection will need to be completed on another day.

Director was advised that the Notice of Site Visit must be posted at the entrance of the facility for a period of 30 days. A copy of this licensing report (LIC809) must also be posted for 30 days. If these requirements are not met, civil penalties in the amount of $100 per violation will be 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: 03/30/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/30/2022
LIC809 (FAS) - (06/04)
Page: 2 of 3
Document Has Been Signed on 03/30/2022 05:06 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: 197492945

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/30/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
04/08/2022
Section Cited

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101174 Disaster and Mass Casualty Plan (b) The plan... shall include: (1) Designation of administrative authority and staff assignments. This requirement was not met as evidence by:
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Based on observation and record review, LPA observed the Emergency Disaster Plan last updated 11/17/16 and observed 4 staff members listed on Plan who no longer work for facility, which poses a potential Health and Safety Risk to children in care.
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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: Carissa BellTELEPHONE: (661) 202-3359
LICENSING EVALUATOR NAME: Brigitte TsutaokaTELEPHONE: (661) 202-3786
LICENSING EVALUATOR SIGNATURE:
DATE: 03/30/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/30/2022
LIC809 (FAS) - (06/04)
Page: 3 of 3