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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364844198
Report Date: 08/15/2024
Date Signed: 08/15/2024 09:45:10 AM

Document Has Been Signed on 08/15/2024 09:45 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:CHILDRESS FAMILY CHILD CAREFACILITY NUMBER:
364844198
ADMINISTRATOR/
DIRECTOR:		CORTNEY CHILDRESSFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(760) 646-2905
CITY:WRIGHTWOODSTATE: CAZIP CODE:
92397
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 2DATE:
08/15/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:08 AM
MET WITH:Heather RoseTIME VISIT/
INSPECTION COMPLETED:
09:45 AM
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Licensing Program Analyst (LPA) Carol Heath conducted a case management incident inspection in response to an Unusual Incident Report (UIR) received via email on August 12, 2024. When LPA arrived, the licensee, Cortney Childress, was not present, so LPA spoke with the assistant, Heather Rose. LPA toured the facility, took a census of the children, and reviewed a video clip. At the time of arrival, there were two preschool children (ages 3 and 4) in the care of the assistant.

Incident Description: On August 9, 2024, an incident occurred where Child #1 (C1) fell and hit her eye on a shelf, resulting in a laceration. The child was taken to the Desert Valley Emergency Room. The Palmdale Regional Office Officer of the Day (OD) received an email from the licensee reporting the UIR.

LPA reviewed the files of Child #1 and Assistant #1, examined the video clip, and obtained a copy of the roster.

Based on the information provided and the interviews conducted, the incident does not appear to have violated Title 22 regulations; therefore, no deficiencies were cited.

An exit interview was conducted, and a copy of the report was read and provided to the assistant, Heather Rose.

SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Carol Heath
LICENSING EVALUATOR SIGNATURE: DATE: 08/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/15/2024
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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