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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197413766
Report Date: 03/03/2022
Date Signed: 03/03/2022 11:11:30 AM


Document Has Been Signed on 03/03/2022 11:11 AM - 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:TUTOR TIME CHILD CARE/LEARNING CENTERFACILITY NUMBER:
197413766
ADMINISTRATOR:WENDY POWELLFACILITY TYPE:
850
ADDRESS:29421 THE OLD ROADTELEPHONE:
(661) 295-1234
CITY:CASTAICSTATE: CAZIP CODE:
91384
CAPACITY:120CENSUS: 55DATE:
03/03/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
10:15 AM
MET WITH:Wendy PowellTIME COMPLETED:
11:20 AM
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On 03/03/22, at 10:15 AM Licensing Program Analyst (LPA's) Leandra Dolliole and Justeene Tamayo met with Director Wendy Powell and Assistant Director Rubi Trejo to conduct an unannounced case management inspection to conduct an additional follow up interview on a self- reported unusual incident report submitted by the facility on 02-14-22. Upon arrival, LPA's observed 55 children and 11 staff members.

Description of incident: On 02-10-22 at approximately 12pm Child #1 was taken by the arm and roughly placed down on the cot during nap time by staff #1.

Based on the information gathered from the interview conducted with the victim additional follow up is needed.

Exit interview was conducted, report was read, and a copy of this report was given to facility director along with a notice of site visit.

SUPERVISOR'S NAME: Mariela RamonTELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Leandra DollioleTELEPHONE: (619) 202-3380
LICENSING EVALUATOR SIGNATURE:
DATE: 03/03/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/03/2022
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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