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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 360911538
Report Date: 12/02/2024
Date Signed: 12/02/2024 12:26:57 PM

Document Has Been Signed on 12/02/2024 12:26 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 CC RO, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME:PSD/HESPERIA HEAD STARTFACILITY NUMBER:
360911538
ADMINISTRATOR/
DIRECTOR:
HALL, PAULETTEFACILITY TYPE:
850
ADDRESS:9352 E AVENUETELEPHONE:
(760) 948-4411
CITY:HESPERIASTATE: CAZIP CODE:
92345
CAPACITY: 105TOTAL ENROLLED CHILDREN: 105CENSUS: 40DATE:
12/02/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:20 AM
MET WITH:Paulette Hall, Site SupervisorTIME VISIT/
INSPECTION COMPLETED:
12:30 PM
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On December 2, 2024, Licensing Program Analyst (LPA) Crystal Ali met with Paulette Hall site supervisor, conduct an unannounced case management inspection. The purpose of the case management (CM) was to follow up on unusual incident report (UIR) received 10/25/24. Incident occurred on 10/16/24 at approximately 10:35am, child#1 was grabbed by the wrist by teacher and child #2 was tripped by the food service staff worker. No known injuries sustained.

Upon arrival, LPA observed 40 preschool and 13 staff member providing care. During this inspection LPA interviewed the food service worker and the teacher. Child was unable to be interviewed due not meeting CCL interview guidelines.

Site Supervisor stated the internal investigation concluded no evidence that the incidents occurred. CM findings for this UIR, are unsubstantiated means there is not a preponderance of the evidence to prove that the incident occurred.

No deficiencies have been cited.



Exit interview conducted with Paulette Hall and Notice of Site Visit. Notice of site visit must remain posted for 30 days.
Claretta YatesTELEPHONE: (661) 202-3318
Crystal AliTELEPHONE: (661) 202-3409
DATE: 12/02/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/02/2024
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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