<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364813683
Report Date: 12/08/2021
Date Signed: 12/08/2021 11:54:45 AM

Document Has Been Signed on 12/08/2021 11:54 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:KIDCARE CHILD DEVELOPMENT CENTERFACILITY NUMBER:
364813683
ADMINISTRATOR:CARMEN RODRIGUEZFACILITY TYPE:
850
ADDRESS:15025 GRAVILLA ROADTELEPHONE:
(760) 955-6466
CITY:VICTORVILLESTATE: CAZIP CODE:
92392
CAPACITY: 24TOTAL ENROLLED CHILDREN: 24CENSUS: 19DATE:
12/08/2021
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Carmen RodriguezTIME COMPLETED:
12:09 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
On 12/08/21 Licensing Program Analysts (LPA's) Justin Dorsey and Babatunde Ibitoye conducted an inspection at the KidCare Child Development Center. The purpose of the inspection was a Plan of Correction visit to review the deficiency cited on 11/08/21. LPA's met with Director Carmen Rodriguez and toured the facility.

The following was observed:
1.) LPA's observed the center added rubber mulch under the outdoor play equipment to absorb children's falls.

Exit interview conducted a copy of this report, Notice of Site Inspection and Deficiency Clearance Letter was left with Director Carmen Rodriguez.
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Justin Dorsey
LICENSING EVALUATOR SIGNATURE: DATE: 12/08/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/08/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 1