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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197409079
Report Date: 09/04/2024
Date Signed: 09/04/2024 12:27:41 PM

Document Has Been Signed on 09/04/2024 12:27 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
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME:PSD ECE TUMBLEWEED CENTERFACILITY NUMBER:
197409079
ADMINISTRATOR/
DIRECTOR:		DR. MELANIE CULVERFACILITY TYPE:
850
ADDRESS:1100 EAST AVENUE R-4TELEPHONE:
(661) 267-9934
CITY:PALMDALESTATE: CAZIP CODE:
93550
CAPACITY: 200TOTAL ENROLLED CHILDREN: 200CENSUS: 120DATE:
09/04/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:45 AM
MET WITH:Elizabeth Mora, Education CoordinatorTIME VISIT/
INSPECTION COMPLETED:
12:35 PM
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On 09/04/24 at 9:45 AM, Licensing Program Analyst (LPA) Justeene Tamayo met with Education Coordinator Elizabeth Mora, who granted access to the facility. The purpose of the inspection was to conduct an unannounced case management inspection for a UIR received at Palmdale RO on 05/07/24. LPA Tamayo was unable to conduct the investigation at the time of the incident received due to the facility went on summer break until middle of August 2024. LPA disclosed the purpose of the inspection. Upon arrival, there were 120 preschool age children in care, along with 22 Teachers.

Description of Incident: On 05/07/24, child #1 stated staff #1 hit them on the shoulder.

During the inspection, LPA interviewed staff, child #1, and other children present at the facility. Child #1 stated that they liked staff #1 and did not mention any forms of punishment or hitting. Staff #2 indicated they did not see any incident involving child #1 being hit. Based on the interviews conducted, there is insufficient evidence to confirm that staff #1 hit child #1 on the shoulder.

No deficiencies have been cited at this time.

An exit interview was conducted, and a copy of this report was provided to Education Coordinator Elizabeth Mora, along with a copy of her appeal rights and Notice of Site Visit.
SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Justeene Tamayo
LICENSING EVALUATOR SIGNATURE: DATE: 09/04/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/04/2024
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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