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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364813683
Report Date: 07/18/2023
Date Signed: 07/20/2023 09:51:19 AM

Document Has Been Signed on 07/20/2023 09:51 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
PALMDALE CHILD CARE, 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: 21DATE:
07/18/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
11:18 AM
MET WITH:Carmen RodriguezTIME COMPLETED:
11:56 AM
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On July 18, 2023 at 11:18am, Licensing Program Analyst (LPA) Kris Diaz conducted an unannounced case management to follow up on a UIR received 6.30.23. LPA met with director Carmen Rodriguez, who took LPA on tour of facility. LPA observed 21 children in care with 2 staff members. LPA observed 14 school-age children in care with 2 staff.

During this inspection, LPA completed confidential interviews 2 staff members S1, S2 and 1 child (C1). The allegations are violation of personal rights.

Description of incident:
"Angel's mother reported that an abrasion that she noticed while giving him his nightly bath was caused by Ms. Laprisha. The injury is an abrasion that looks like the skin was scapped on a rough surface. Picture is enclosed. It's unknown where the abrasion happened because mom noticed it at shower time."

A safety inspection was completed where zero deficiencies were noted.

Due to the need to gather additional information, further investigation is needed.

Notice of Site Visit was given and shall be posted for thirty (30) consecutive days. Failure to maintain posting as required will result in a $100 civil penalty.

An exit interview was conducted and a signed copy of this report, the Notice of Site Visit and Appeal rights have been provided to Director Carmen Rodriguez

The report was discussed and left with the Center Director, Carmen Rodriguez.
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Kristina Diaz
LICENSING EVALUATOR SIGNATURE: DATE: 07/18/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/18/2023
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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