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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 360911538
Report Date: 02/09/2023
Date Signed: 02/09/2023 12:41:57 PM


Document Has Been Signed on 02/09/2023 12:41 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/HESPERIA HEAD STARTFACILITY NUMBER:
360911538
ADMINISTRATOR:HALL, PAULETTEFACILITY TYPE:
850
ADDRESS:9352 E AVENUETELEPHONE:
(760) 948-4411
CITY:HESPERIASTATE: CAZIP CODE:
92345
CAPACITY:105CENSUS: 62DATE:
02/09/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
10:29 AM
MET WITH:Paulette Hall, Site SupervisorTIME COMPLETED:
12:45 PM
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On February 9, 2023, at 10:29 AM Licensing Program Analyst (LPA's) Kuliema Calloway and Kristina Diaz and LPM, Claretta Yates made an unannounced Case Management (Incident) Inspection to PSD/Hesperia Head Start LPA met with Paulette Hall who granted access to the facility. At the time of LPA's arrival, there were a total of (62) day-care children and 14 staff. Ages of the children were 3 to 5 years old.

The purpose of the Case Management Inspection was to follow up on a Unusual incident report, which was submitted to the Department on January 26, 2023. The incident report involved an allegation alleging staff 1 (S1) violated the personal rights of child 1 (C1).

During the inspection, LPA completed confidential interviews with none of the day-care children and 4 Staff. LPA obtained the facility roster.

A safety inspection was completed where no deficiencies were noted.

Due to the need to gather additional information, further investigation is needed.

Notice of site visit was given and must remain posted for 30 days.

An exit interview was conducted

The report was discussed and left with the Site Supervisor, Paulette Hall.


SUPERVISOR'S NAME: Claretta YatesTELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Kuliema CallowayTELEPHONE: (661) 202-3381
LICENSING EVALUATOR SIGNATURE:
DATE: 02/09/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/09/2023
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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