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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 367750029
Report Date: 10/24/2023
Date Signed: 10/24/2023 03:06:55 PM


Document Has Been Signed on 10/24/2023 03:06 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
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551



FACILITY NAME:KIDS & CARE, INC.FACILITY NUMBER:
367750029
ADMINISTRATOR:CLAUDIA V. GARCIAFACILITY TYPE:
830
ADDRESS:10522 MANHASSET ROADTELEPHONE:
(760) 956-5000
CITY:APPLE VALLEYSTATE: CAZIP CODE:
92308
CAPACITY:8CENSUS: 4DATE:
10/24/2023
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
02:48 PM
MET WITH:Patricia Jacobs, Director TIME COMPLETED:
03:15 PM
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On 10/24/2023, Licensing Program Analyst (LPA) Justeene Tamayo met with Director Patricia Jacob's, for the purpose to conduct a Case Management visit-Plan of Correction for the Type A deficiencies that were cited on 09/22/23, 09/26/23 and 10/03/23 for being over capacity. Upon arrival LPA observed 4 sleeping infants in care with 3 Teachers. The Center also Licensed for a preschool component (X367750031)and a School age component (X367750030) on the same premises.

The purpose of the visit is to conduct a Plan Of Correction Visit to ensure the center meets State Licensing Title 22 Regulations: Limitation on Capacity Section 101161(a) and Fire Clearance 101171(a).

A tour of the facility was conducted along with the Director. No deficiencies have been cited at this time. Facility is in compliance with Title 22 regulations.

An exit interview was conducted, and a copy of this report was read and provided to Director Patricia Jacob's, along with a Notice of Site Visit and appeal rights.
SUPERVISOR'S NAME: Mariela RamonTELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Justeene TamayoTELEPHONE: 661-202-3796
LICENSING EVALUATOR SIGNATURE:
DATE: 10/24/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/24/2023
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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