334805043-10-30-2024-10-CC-AFLS-DAJR9B-20241030124916

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 334805043
Report Date: 10/30/2024
Date Signed: 10/30/2024 12:49:19 PM

Document Has Been Signed on 10/30/2024 12:49 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, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME:	PALM VALLEY PRESCHOOL		FACILITY NUMBER:	334805043
ADMINISTRATOR/ DIRECTOR:	JENNIFER TRAUB		FACILITY TYPE:	850
ADDRESS:	35-525 DA VALL DRIVE		TELEPHONE:	(760) 328-0861
CITY:	RANCHO MIRAGE	STATE: CA	ZIP CODE:	92270
CAPACITY: 178	TOTAL ENROLLED CHILDREN: 178	CENSUS: 23	DATE:	10/30/2024
TYPE OF VISIT:	Case Management - Incident	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	11:56 AM
MET WITH:	Jennifer Traub		TIME VISIT/ INSPECTION COMPLETED:	01:20 PM

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On October 30, 2024, at 11:56 AM, Licensing Program Analyst (LPA) Anastasia Flores, and Investigator, Jesus Gonzalez, arrived for the purpose of an incident that occurred in the facility on, 10/17/24 with Child #1 (C1). LPA and Investigator conducted inspection of the area C1 was injured and conducted interview with two staff. (S1, S2).

On 10/17/24, C1 was running on tip toes and fell, hitting the mouth on the right side of the toddler slide. The parent of C1 was immediately called and C1 was taken to the Emergency room. LPA toured the facility, and no immediate health or safety concerns were observed, and the facility is operating within the ratio.

Based on the evidence received and interviews conducted there was no evidence of a deficiency to be issued. The facility acted as needed for care of C1.

An exit interview was conducted and a copy of this report, appeal rights and Confidential Names List (LIC811) was handed to Administrator, Jennifer Traub.

A notice of Site Visit was given and must remain posted for 30 days.

Pauline Beschorner	TELEPHONE: (951) 782-6641
Anastasia Flores	TELEPHONE: (951) 533-2031
	DATE: 10/30/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/30/2024

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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