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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364842463
Report Date: 02/24/2021
Date Signed: 02/24/2021 02:28:26 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME:CREATIVE MIND LEARNING CENTERFACILITY NUMBER:
364842463
ADMINISTRATOR:AGUILAR, SYLIVIAFACILITY TYPE:
840
ADDRESS:15089 MESA STREETTELEPHONE:
(760) 949-5300
CITY:HESPERIASTATE: CAZIP CODE:
92345
CAPACITY:22CENSUS: 7DATE:
02/24/2021
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Sylivia AguilarTIME COMPLETED:
11:30 AM
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Licensing Program Analyst (LPA) Thompson-Miller met with Director, Sylivia Aguilar, for a Case Management Incident inspection involving an Incident Report dated January 27, 2021. The incident occurred approximately December 7, 2020. Due to COVID-19 this inspection will be conducted via Telephone call.

Description of the incident: Child #5 alleges Child #4 grabbed her causing an inappropriate touch. Interviews were conducted with staff, parents and children. Footage of the film/video was reviewed by legal guardians of the two children involved and LPA Thompson-Miller. There was no inappropriate touching by either child observed.

Based on information provided and interviews conducted the incident does not appear to have been the result of any violation of the Title 22 regulation, therefore, no deficiencies were cited.

An exit interview was conducted and a copy of this report was read and forwarded to the Director, Sylivia Aguilar, via email and mail for confirmation with "Read Receipt" on this date. The Notice of Site Visit was emailed and mailed to Director.
SUPERVISOR'S NAME: Claretta YatesTELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Linda Thompson-MillerTELEPHONE: (661) 568-8186
LICENSING EVALUATOR SIGNATURE:

DATE: 02/24/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/24/2021
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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