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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197408048
Report Date: 05/01/2024
Date Signed: 05/01/2024 02:36:52 PM

Document Has Been Signed on 05/01/2024 02:36 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:PALMDALE SCH. DIST.-CHAPARRAL HEAD START/STATE PREFACILITY NUMBER:
197408048
ADMINISTRATOR/
DIRECTOR:		DR. MELANIE CULVERFACILITY TYPE:
850
ADDRESS:37500 50TH STREET EASTTELEPHONE:
(661) 575-8959
CITY:PALMDALESTATE: CAZIP CODE:
93552
CAPACITY: 142TOTAL ENROLLED CHILDREN: 142CENSUS: 1DATE:
05/01/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:01 PM
MET WITH:Kelly BallardTIME VISIT/
INSPECTION COMPLETED:
02:42 PM
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On 5.1.24 LPA Diaz conducted a Case Management Inspection for an incident reported to Palmdale RO on 4.24.24. LPA met with Facility Representative, Kelly Ballard who granted access to the classroom. The purpose of the visit was to follow-up on the UIR. At the time of the inspection it was dismissal time and one child was present with 3 staff.

LPA observed child leaving with parent and heard child identified as C1. LPA asked if I could speak with C1 and P1 for a short conversation. See LIC 812 for documentation of conversation with C1 and P1. LPA spoke with S1 and S2 and concluded that there are no violations.

LPA conducted a safety inspection and zero deficiencies were found.

LPA conducted this inspection in person. The report was read with Facility Representative, Kelly Ballard. A Notice of Site Visit was given and must be posted for 30 days. Exit interview conducted.
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Kristina Diaz
LICENSING EVALUATOR SIGNATURE: DATE: 05/01/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/01/2024
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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