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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364830080
Report Date: 02/20/2024
Date Signed: 02/20/2024 01:22:50 PM


Document Has Been Signed on 02/20/2024 01:22 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:KINDERCARE LEARNING CENTERFACILITY NUMBER:
364830080
ADMINISTRATOR:BRIANNE HINDMANFACILITY TYPE:
850
ADDRESS:13615 BEAR VALLEY ROADTELEPHONE:
(760) 949-8539
CITY:VICTORVILLESTATE: CAZIP CODE:
92392
CAPACITY:88CENSUS: 83DATE:
02/20/2024
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
01:02 PM
MET WITH:Jeannette Honnold, Facility RepresentativeTIME COMPLETED:
01:30 PM
NARRATIVE
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On February 20, 2024, Licensing Program Analyst (LPA) Calloway and Braddock made an unannounced inspection at the facility above. LPAs met with facility representative, who granted access. LPAs toured the facility and observed eight three (83) active day care children and nine (9) staff.

Licensing received a packet of information within 10 days of the center director changing, upon review it does not meet the qualifications to qualify the facility representative as the center director.

Per Title 22 regulations, Division 12, Chapter 1 there is a Type B deficiency cited during this inspection for 101212 (b)(1)(A), for Reporting Requirements. See 809 D page.

Exit interview was conducted, a copy of this report was read, and a notice of site visit, appeal rights, were provided to facility representative S1 at the facility. Failure to maintain notice of site visit, will result in $100 civil penalty.

SUPERVISOR'S NAME: Claretta YatesTELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Kuliema CallowayTELEPHONE: (661) 202-3381
LICENSING EVALUATOR SIGNATURE:
DATE: 02/20/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/20/2024
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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Document Has Been Signed on 02/20/2024 01:22 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
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551


FACILITY NAME: KINDERCARE LEARNING CENTER
FACILITY NUMBER: 364830080

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/20/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/25/2024
Section Cited
CCR
101212(b)(1)(A)

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101212(b)(1)(A) Reporting Requirements (b) The name of the child care center director...(1)Whenever a change in child care center director is reported...(A)Verification of the completion of the course work...This requirement was not met as evidenced by:
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Per facility representative the course work will be completed and submitted to Licensing by the chosen POC date 3/25/24. Per facility representative class is available on 3/23/24.
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Based on observeration and record review the packet of information sent for director qualifilcations did not meet the full requirements which is a potential health, safety, or personal rights risk for the persons 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: Claretta YatesTELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Kuliema CallowayTELEPHONE: (661) 202-3381
LICENSING EVALUATOR SIGNATURE:
DATE: 02/20/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/20/2024
LIC809 (FAS) - (06/04)
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