Department of
SOCIAL SERVICES
Community Care Licensing
FACILITY EVALUATION REPORT
Facility Number:
367750029Report Date:05/29/2024
Date Signed:05/29/2024 02:00:22 PM
Document Has Been Signed on 05/29/2024 02:00 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. GARCIA | FACILITY TYPE: | 830 | |
| ADDRESS: | 10522 MANHASSET ROAD | TELEPHONE: | (760) 956-5000 | |
| CITY: | APPLE VALLEY | STATE: CA | ZIP CODE: | 92308 |
| CAPACITY: | 8 | CENSUS: 1 | DATE: | 05/29/2024 |
| TYPE OF VISIT: | Annual/Required | UNANNOUNCED | TIME BEGAN: | 09:30 AM |
| MET WITH: | Patricia Jacobs, Director | TIME COMPLETED: | 02:00 PM | |
NARRATIVE | ||
1 | On 05/29/2024, Licensing Program Analysts (LPAs) Justeene Tamayo and Sherell Braddock met with the facility Director, Patricia Jacobs for the One Year Required inspection for the infant license in accordance with the facility sketch. A tour of the facility was conducted. Upon arrival LPAs observed a total of 1 infant. There was 1 lead teacher supervising the infant child. The hours of operation are Monday - Friday 6AM-6PM. The Center also Licensed for a Preschool component (X367750031) and a School Age component (X367750030) on the same premises. Incidental Medical Services (IMS) were discussed.Indoor/Children’s Area: Child care center is clean, safe, sanitary and in good repair; all outdoor and indoor passageways, stair ways, incline, ramps, open porches and other areas of potential hazard are kept free of obstruction; floors of all rooms have a surface that is safe and clean, cleaning compounds inaccessible, poisons locked, furniture/equipment is good condition, free of flies, other insects, rodents; tables/chairs provided to meet children’s needs; all play equipment and materials used by children are age-appropriate, each child has an individual permanent or portable storage space (cubby, individually labelled with name) for his/her clothing, personal belongings and or bedding (stored separately). There is a working telephone. All materials and surfaces are toxic free are inaccessible, no fireplace. Fire extinguisher (2A10BC), smoke detector, and carbon monoxide detector is in operable condition. | |
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| I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. | ||||||
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| LIC809 (FAS) - (06/04) | Page: 1 of 5 |
| STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY FACILITY EVALUATION REPORT (Cont) | 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 |
 | VISIT DATE: 05/29/2024 |
NARRATIVE | |
1 | Restrooms: LPAs observed a changing table for the infants. LPA observed soap, toilet paper and paper towels readily available. Water temperature is appropriate. There is an isolation area for children who become ill while in care located in the Directors Office. Facility maintains a comfortable temperature at all times, first aid supplies (thermometer, bandages, scissors), sign in/out sheets (manually and electronically) available and completed daily. No Smoking prohibited on the premises, daily inspection for illness, no prohibited child care items observed. Firearms/weapons are not allowed or stored on premises. There is no body of water on the premises. Napping: Infants nap in the napping area. Cribs are readily available. Outdoor: The facility has one playground area for the infants near the front entrance. Outdoor play equipment was inspected for health, safety, good repair and age appropriateness. There is concrete areas for active play. The area was observed to be free of debris, free from hazard, holes, broken items, debris, cushioning material underneath. No bodies of water were observed. There are areas for shade and rest. |
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| I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. | ||||||
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| LIC809 (FAS) - (06/04) | Page: 2 of 5 |
| STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY FACILITY EVALUATION REPORT (Cont) | 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 |
| VISIT DATE: 05/29/2024 |
NARRATIVE | |
1 | Teacher child ratios were observed and staff name recorded. Care and supervision was evaluated to determine if the basic needs of children are met and appropriate. Health Related Services: Medications inaccessible to children; all prescription and non-prescription medications have child’s name and are dated; written consent and instruction from child’s representative, a plan to document and report to child’s representative when medication is administered to a child; IMS plan on file (if applicable). Children are inspected for illnesses (wellness policy) as they arrive. A review of medication policy indicated that prescription medication is administered only with parent's written permission (licensing medication form- LIC9221 - also used). LPA advised the Director, must administer medication, and document the dosage, date and time onto a log. Medication can be brought and taken home by the parent daily. Medication will be properly labeled and stored in its original container.This facility provides Incidental Medical Services – IMS. Currently no IMS. Food Service: LPAs observed formula in the cabinet area, as well as a refrigerator for the bottles to be kept in. Per Director, the parents have the option of bringing their own formula. Formula is also provided by the center. Food allergy list is posted in the classroom, as well as posted on the kitchen refrigerator. |
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| I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. | ||||||
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| LIC809 (FAS) - (06/04) | Page: 3 of 5 |
| STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY FACILITY EVALUATION REPORT (Cont) | 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 |
| VISIT DATE: 05/29/2024 |
NARRATIVE | |
1 | Staff/Personnel Records: Director (qualified) qualifications were verified, Designation of Responsibility observed, immunization's, TB clearance, health screening, criminal record statement, statement acknowledging suspected child abuse and mandated reporter were observed in file. Facility Records: Roster, fire/disaster drill log last completed on 05/28/2024. CPR/First Aid, and mandated report training were reviewed. Posting Requirements: Failure to comply with posting requirements shall result in an immediate civil penalty.The following were observed posted as required: facility license, Personal Rights (LIC613A), Parent’s Rights Poster (PUB 394L), emergency disaster plan, earthquake preparedness checklist. Documents Provided and or Discussed: Forms and records to keep at the facility and IMS. Advisory/Other: First Aid kit was observed with supplies (thermometer) readily available. CPR/First Aid expires on 09/06/2025. Mandated Reporter Training expires on 07/20/2024. Electrical outlets are inaccessible, recalled and or prohibited toys/play equipment were not observed on the premises. There are no window cords accessible to children. Sign in and out sheets were reviewed. The parent board was reviewed and has all of the required forms posted. Fire/earthquake drills current. Roster current. |
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| I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. | ||||||
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| LIC809 (FAS) - (06/04) | Page: 4 of 5 |
| STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY FACILITY EVALUATION REPORT (Cont) | 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 |
| VISIT DATE: 05/29/2024 |
NARRATIVE | |
1 | Director advised of the requirement to report Unusual Incidents. Director informed to utilize the Unusual Incident Report/Injury Report LIC624B when submitting the report to the department (email address on the website: www.unusualincidentreport@dss.ca.gov). A report shall be made to the department by telephone or fax during the department's normal business hours before the close of the next working day following the occurrence during the operation of family day care home. In addition, a written report shall be submitted to the department within seven days following the occurrence of any events specified above.Director was reminded that all adults 18 and over, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.Any duly authorized officer, employee, or agent of the Department shall, upon presentation of proper identification, shall inspect the facility. Director shall permit the Department to inspect the family child care home, and to privately interview children or staff, to determine compliance with or to prevent violations of child care center or regulations, also enter and inspect any place providing personal care, supervision and services at any time, with or without advance notice, to secure compliance with, or to prevent a violation. To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process No deficiencies were cited at this time. A notice of site visit was given and must remain posted for 30 days.Failure to comply with posting requirements shall result in an immediate civil penalty of $100. No deficiency. The On Duty Worker is available for questions at (661) 202-3318 Monday through Friday 8am-5pm.Exit interview conducted and report was reviewed with Director Patricia Jacobs. This report was read and provided to the Director, along with her appeal rights and Notice of Site Visit. |
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| I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. | ||||||
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| LIC809 (FAS) - (06/04) | Page: 5 of 5 |
