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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364844265
Report Date: 11/29/2023
Date Signed: 11/29/2023 03:23:01 PM

Document Has Been Signed on 11/29/2023 03:23 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:READY SET GROW LEARNING SERVICESFACILITY NUMBER:
364844265
ADMINISTRATOR:LILAMANIE SENEWIRATNEFACILITY TYPE:
840
ADDRESS:1528 PUMALO STREETTELEPHONE:
(909) 883-6628
CITY:SAN BERNARDINOSTATE: CAZIP CODE:
92404
CAPACITY: 39TOTAL ENROLLED CHILDREN: 22CENSUS: 0DATE:
11/29/2023
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
12:01 PM
MET WITH:Facility Representative Zaray Ochoa TIME COMPLETED:
12:30 PM
NARRATIVE
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On November 29, 2023, at 12:01 p.m., Licensing Program Analyst (LPA) Kendal Zirbes conducted an unannounced case management deficiency inspection and met with facility representative Zaray Ochoa. LPA disclosed the purpose of the inspection and was granted entry into the facility. Zero school age children were present in the facility during this inspection.

On October 9, 2023, the Department was informed of an incident that occurred at the Center on an unknown date within the previous year. According to the information received, while the school age children were in the enclosed outdoor activity space, a group of neighborhood children and adults, not associated with the Center were also outside, in an adjacent lot. According to the interviewees, an unknown individual not associated with the Center revealed a weapon over the brick wall which was observed by child (C1). C1 reported the incident to a staff member and the children were brought inside the Center. The Center reported the incident to the police and C1 authorized representative. Upon hearing about the incident, LPA requested a copy of the unusual incident report from staff 1 (S1). S1 was unable to provide a copy of the report to the Department. LPA completed a review of the facility file, which revealed zero evidence that the Center reported this incident to the Department. This incident was unusual and threatened the physical, and emotional health or safety of C1, therefore the incident was required to be reported to the Department. The facility failed to meet the reporting requirements.

Based on the interviews conducted and a review of the records, a citation was issued on the attached LIC 809D for California Code of Regulations, Title 22, Division 12, Chapter 1, regulation 101212 (d)(1)(C).

Notice of Site Visit was given and must remain posted for 30 days. An exit interview was conducted, and the report was reviewed with facility representative Zaray Ochoa.
SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Kendal Zirbes
LICENSING EVALUATOR SIGNATURE: DATE: 11/29/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/29/2023
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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Document Has Been Signed on 11/29/2023 03:23 PM - It Cannot Be Edited


Created By: Kendal Zirbes On 11/29/2023 at 12:03 PM
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: READY SET GROW LEARNING SERVICES
FACILITY NUMBER: 364844265

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/29/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
12/08/2023
Section Cited
CCR
101212(d)(1)(C)

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101212 Reporting Requirements (d) …during the operation of the child... (1) Events reported... (C) Any unusual incident or child absence that threatens the physical or emotional health...of any child. This requirement is not met as evidenced by:
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Per facility representative, the Center will report any unusual incidents to the Department with the required time frame.
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Based on interviews and records review, the Center failed to report an unusual incident involving C1 being shown a weapon at the Center. This incident threatened the physical or emotional health of C1, which posed a potential Health or Safety risk to 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:Lady King
LICENSING EVALUATOR NAME:Kendal Zirbes
LICENSING EVALUATOR SIGNATURE:
DATE: 11/29/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/29/2023


LIC809 (FAS) - (06/04)
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