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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197750002
Report Date: 05/04/2023
Date Signed: 05/04/2023 03:59:35 PM

Document Has Been Signed on 05/04/2023 03:59 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:KCE CHAMPIONS LLC @ILEAD-LANCASTERFACILITY NUMBER:
197750002
ADMINISTRATOR:JESSICA CARRIZALFACILITY TYPE:
840
ADDRESS:254 EAST AVENUE K-4TELEPHONE:
(661) 483-9947
CITY:LANCASTERSTATE: CAZIP CODE:
93535
CAPACITY: 100TOTAL ENROLLED CHILDREN: 100CENSUS: 30DATE:
05/04/2023
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
02:50 PM
MET WITH:Latasha Mauldin, DirectorTIME COMPLETED:
04:14 PM
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Licensing Program Analyst (LPA) Maddox met with Director, Latasha Mauldin today for the purpose of conducting a Plan of Correction (POC) inspection. This POC inspection is conducted to clear citations issued on 4/20/2023.

LPA was able to clear citation the following citations:
Staff files were available for review
Staff have completed Mandated Reporter training
An emergency disaster drill was conducted on 4/21/2023
The area in the rear of the classroom now has a large accordion wall blocking the area where the large wood slats are located making the area inaccessible
Additional bathrooms are available for children in the main area of the school
LPA observed the trash can now has a lid; copy of license is available

LPA was not able to clear citation for Building and Grounds - there was also a cart and dry erase board that should be placed in storage area; still no evidence of water testing.

LPA will allow an extension of 1 week to verify additional corrections. Exit interview conducted, copy of report read and signed by Director, copy of report left at facility.
SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Donna Maddox
LICENSING EVALUATOR SIGNATURE: DATE: 05/04/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/04/2023
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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