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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197403566
Report Date: 05/25/2023
Date Signed: 05/25/2023 12:39:16 PM


Document Has Been Signed on 05/25/2023 12:39 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:
197403566
ADMINISTRATOR:GENESIS BENITEZFACILITY TYPE:
850
ADDRESS:44400 FOXTONTELEPHONE:
(661) 948-1767
CITY:LANCASTERSTATE: CAZIP CODE:
93535
CAPACITY:66CENSUS: 15DATE:
05/25/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Genesis BenitezTIME COMPLETED:
12:40 PM
NARRATIVE
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On 05/25/2023 at 9:00 A.M., Licensing Program Analyst (LPA) Joselito L. Del Mundo conducted a case management inspection at KinderCare Learning Center. LPA met with Director Genesis Benitez. LPA stated purpose of the inspection was to follow-up on a self-reported Unusual Incident Report (UIR) that happened on 05/15/2023 at the center. LPA observed 15 children and 2 staff.

Description of the incident: The incident indicates that child 1 was left alone without direct supervision of a teacher.

During the inspection, LPA interviewed 2 staff and 3 children. LPA was not able to interview teacher #3. Per Director Benitez, she is no longer working for the center effective 05/23/2023.

Based on the information gathered, it revealed that a child #1 was left alone without the direct supervision and visual observation of the facility staff. This is an immediate health and safety violation. Therefore, a Type A deficiency is being cited.

Upon receipt of a Type A deficiency licensee shall post the report for 30 days in addition to the Notice of Site Visit & provide copies of the licensing report to parents/guardians of children in care at the facility. This report must be provided to parents/guardians of children newly enrolled at the facility during the next 12 months & licensee will obtain a signed Acknowledgement of Licensing Reports (LIC 9224) from parent/guardian & place it in each child's file. If these requirements are not met, civil penalties will be assessed.

LIC 9213 Notice of Site Visit was left at facility and must be posted for 30 days. Failure to do so will result in an immediate civil penalty assessment of $100.00.



Exit interview was conducted, Appeal Rights and a copy of this report were provided to Director Genesis Benitez.
SUPERVISOR'S NAME: Lady KingTELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Joselito DelMundoTELEPHONE: (661) 202-3491
LICENSING EVALUATOR SIGNATURE:
DATE: 05/25/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/25/2023
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 05/25/2023 12:39 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: 197403566

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/25/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
05/25/2023
Section Cited
CCR
101229(a)(1)

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101229 Responsibility for Providing Care and Supervision
(a) The licensee shall provide care and supervision as necessary to meet the children's needs.
(1) No child(ren) shall be left without the supervision of a teacher at any time, except as specified in Sections 101216.2(e)(1) and 101230(c)(1). Supervision shall include visual observation.
This requirement is not met as evidenced by:
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Director will review the operating procedure to staff when taking children outside of the center.

Director shall provide training to staff under section 101229(a)(1) and provide proof of the training to the department.
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Child #1 was left without the direct supervision and visual observation of facility staff which posed an immediate Health, Safety or Personal Rights risk to 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: Lady KingTELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Joselito DelMundoTELEPHONE: (661) 202-3491
LICENSING EVALUATOR SIGNATURE:
DATE: 05/25/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/25/2023
LIC809 (FAS) - (06/04)
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