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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 367750010
Report Date: 10/21/2019
Date Signed: 10/21/2019 04:59:48 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1605 EAST PALMDALE BLV, STE A
PALMDALE, CA 93550
FACILITY NAME:ADVENTUROUS LEARNING GROUP, INCFACILITY NUMBER:
367750010
ADMINISTRATOR:SALTZMAN, ERICAFACILITY TYPE:
840
ADDRESS:15011 BEAR VALLEYTELEPHONE:
(760) 948-5500
CITY:HESPERIASTATE: CAZIP CODE:
92345
CAPACITY:10CENSUS: 10DATE:
10/21/2019
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
03:33 PM
MET WITH:Erica SaltzmanTIME COMPLETED:
05:14 PM
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Licensing Program Analyst (LPA) Thompson-Miller met with Erica Saltzman, Director for a Case Management Incident inspection involving an Incident Report dated 09/10/19. The incident occurred on September 9, 2019.

Description of the incident: Child #1 was inappropriately touched with a marker by Child #2. Child #1 and Child #2 were in route to the center when the two children engaged in inappropriate activity. Interviews were conducted on 9/18/19 with parents and Child #1. Interview conducted with staff and photo of van was taken.

Based on information provided and interview with Staff #1 the incident needs further investigation. Exit interview conducted and a copy of report provided to Erica Saltzman, Director on this date.
SUPERVISOR'S NAME: Carissa BellTELEPHONE: (661) 789-6953
LICENSING EVALUATOR NAME: Linda Thompson-MillerTELEPHONE: (661) 568-8186
LICENSING EVALUATOR SIGNATURE:

DATE: 10/21/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/21/2019
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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