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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364830080
Report Date: 08/27/2024
Date Signed: 09/05/2024 05:01:33 PM


Document Has Been Signed on 09/05/2024 05:01 PM - It Cannot Be Edited

Document is an Amendment of Original Document on 09/05/2024 04:48 PM

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

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THIS REPORT WAS AMENDED FROM THE ORIGINAL REPORT DATED 8/27/2024

On August 27, 2024, Licensing Program Analyst (LPA), Calloway conducted an unannounced case management inspection to the above facility. LPA met with the facility representative who granted access. LPA toured the facility with the representative and observed eight two (82) day care children and seven (7) staff in care.

On August 19, 2024, there was an Unusual Incident Report (UIR) received at the Palmdale Regional Office for an incident that occurred on August 16, 2024, where Child 1 fell during play time. LPA observed the play area, conducted interviews, and obtained a copy of the injury procedures. Although, the incident could not have been prevented, the staff should be able to always provide appropriate supervision and not leave the area before supervision coverage is in place.

There are no deficiencies cited during this inspection. There is a Technical Violation issued. See TV page attached to this report.

Exit interview was conducted and a copy of this report was read, a Notice of Site Visit, were provided to Jeannette Honnold, Facility Representative. 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: 08/27/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/27/2024
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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