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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 360911142
Report Date: 12/06/2023
Date Signed: 12/06/2023 04:43:12 PM


Document Has Been Signed on 12/06/2023 04:43 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
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551



FACILITY NAME:PSD/VICTORVILLE HEAD STARTFACILITY NUMBER:
360911142
ADMINISTRATOR:LUCY ANGELA NARANJOFACILITY TYPE:
850
ADDRESS:14029 AMARGOSA ROAD, STE. CTELEPHONE:
(760) 245-9147
CITY:VICTORVILLESTATE: CAZIP CODE:
92392
CAPACITY:95CENSUS: 39DATE:
12/06/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
02:04 PM
MET WITH:Keosha Smith, Site SupevisorTIME COMPLETED:
02:30 PM
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On December 6, 2023, Licensing Program Analyst (LPA) Calloway made an unannounced inspection to the facility. LPA met with Site Supervisor who granted access. The purpose was to conduct a Case Management inspection for a UIR that was submitted via email 11/29/23 to the Palmdale Regional Office.

On 11/28/2023, the mother of C1 picked up the child and noticed bruising on the child's arm between elbow and the ribs about quarter size. P1 blamed teacher S1
and stated they would be filing a police report. P1 stated scratches and bruises were found all over C1's body and staff does not know where the bruises came from. The facility called CPS because the child seemed fine and was not in pain. There was a police report and CPS case filed and report numbers were given on the UIR report.

During the inspection, LPA obtained a copy of the facility roster, and conducted confidential interview with S1. C1 and S2 were not present during the time of inspection.

Exit interview was conducted and a copy of this report was read, a Notice of Site Visit, and Appeal Rights were provided to Keosha Smith, Site Supervisor at the facility. A Notice of Site Visit must remain posted for thirty (30) consecutive days. Failure to maintain posting will result in a $100 civil penalty.
SUPERVISOR'S NAME: Claretta YatesTELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Kuliema CallowayTELEPHONE: (661) 202-3381
LICENSING EVALUATOR SIGNATURE:
DATE: 12/06/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/06/2023
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: PSD/VICTORVILLE HEAD START
FACILITY NUMBER: 360911142
VISIT DATE: 12/06/2023
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Summary: This bill amends Health and Safety Code (HSC) sections 1596.859, 1596.8595, 1596.8895, and 1597.05 to improve the transparency of licensing records and to ensure that parents/guardians using a licensed childcare facility are aware of situations that present a danger to children.

Per Title 22 Regulations, there are deficiencies cited during this inspection. See 809 D pages.

Exit interview was conducted and a copy of this report was read, a Notice of Site Visit, and Appeal Rights were provided to Keosha Smith, Site Supervisor at the facility. A Notice of Site Visit must remain posted for thirty (30) consecutive days. Failure to maintain posting will result in a $100 civil penalty.
SUPERVISOR'S NAME: Claretta YatesTELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Kuliema CallowayTELEPHONE: (661) 202-3381
LICENSING EVALUATOR SIGNATURE:

DATE: 12/06/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/06/2023
LIC809 (FAS) - (06/04)
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