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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364830313
Report Date: 12/17/2024
Date Signed: 12/17/2024 10:26:35 AM

Document Has Been Signed on 12/17/2024 10:26 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:VISTA VERDE STATE PRESCHOOLFACILITY NUMBER:
364830313
ADMINISTRATOR/
DIRECTOR:		JANE CHASEFACILITY TYPE:
850
ADDRESS:13403 VISTA VERDE STREETTELEPHONE:
(760) 662-5650
CITY:VICTORVILLESTATE: CAZIP CODE:
92392
CAPACITY: 48TOTAL ENROLLED CHILDREN: 48CENSUS: 15DATE:
12/17/2024
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:45 AM
MET WITH:Danielle SalazarTIME VISIT/
INSPECTION COMPLETED:
10:30 AM
NARRATIVE
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On December 17, 2024, Licensing Program Analyst (LPA), Calloway conducted an unannounced case management inspection to the above facility. LPA met with a facility representative who granted access. LPA toured the facility with the representative and observed fifteen-day care children and three staff in care.

On March 27, 2024, an annual inspection was conducted at the facility above and there was a deficiency issued for the facility not reporting to the licensing department within ten days the new facility director or site supervisor. The deficiency has not been corrected.

Per Title 22, Division 12, Chapter 1, there is a repeat Type B deficiency cited during this inspection 101212(b) for Reporting Requirements. See 809D page.

Exit interview was conducted and a copy of this report was read, a Notice of Site Visit, and Appeal Rights were provided to Danielle Salazar, Representative at the facility. A Notice of Site Visit must remain posted for thirty (30) consecutive days. Failure to maintain posting will result in a $100 civil penalty.

SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Kuliema Calloway
LICENSING EVALUATOR SIGNATURE: DATE: 12/17/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/17/2024
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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Document Has Been Signed on 12/17/2024 10:26 AM - It Cannot Be Edited


Created By: Kuliema Calloway On 12/17/2024 at 10:13 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: VISTA VERDE STATE PRESCHOOL
FACILITY NUMBER: 364830313

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/17/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
01/17/2025
Section Cited
CCR
101212(b)

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101212(b)- Reporting Requirements (b) the name of the child care center director, and any fully qualified teacher(s) designated to act in child care center director's absence, shall be reported to the Department within 10 days...This requirement has been met as evidenced by:
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I will contact the District Office and have them to talk to the principal or person in charge of the preschool to see how it can be resolved.
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Based on observation, interview, and record review the new site supervisor or director has not been reported to the Licensing Department which poses a potential health, safety, or personal rights risk to the persons in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Claretta Yates
LICENSING EVALUATOR NAME:Kuliema Calloway
LICENSING EVALUATOR SIGNATURE:
DATE: 12/17/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/17/2024


LIC809 (FAS) - (06/04)
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