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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197417593
Report Date: 05/11/2022
Date Signed: 05/11/2022 02:24:04 PM

Document Has Been Signed on 05/11/2022 02:24 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:KAI'S JUSTICE LEARNING ACADEMYFACILITY NUMBER:
197417593
ADMINISTRATOR:ADAMS, ALLEAFACILITY TYPE:
850
ADDRESS:2739 W. AVENUE LTELEPHONE:
(661) 718-3614
CITY:LANCASTERSTATE: CAZIP CODE:
93536
CAPACITY: 77TOTAL ENROLLED CHILDREN: 77CENSUS: 23DATE:
05/11/2022
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
01:34 PM
MET WITH:Allea AdamsTIME COMPLETED:
02:38 PM
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On 05/11/22 Licensing Program Analyst (LPA) Justin Dorsey conducted an Inspection at Kai's Justice Learning Academy. The purpose of the inspection was a Plan of Correction to review the deficiencies cited on 04/26/22. LPA Dorsey met with Director Eboni Mathias and toured the facility. Licensee Allea Adams later arrived to the facility to aide LPA with the visit.

The following was observed:
1.) LPA Dorsey observed all staff in the classrooms were fingerprint cleared.
2.) LPA Dorsey observed all classrooms were in ratio.

Exit interview conducted a copy of this report, Notice of Site Inspection and Deficiency Clearance Letter was left with Licensee Allea Adams.
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Justin Dorsey
LICENSING EVALUATOR SIGNATURE: DATE: 05/11/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/11/2022
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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