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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 153905169
Report Date: 03/08/2023
Date Signed: 04/10/2023 11:34:04 AM


COMPREHENSIVE INSPECTION

Document Has Been Signed on 04/10/2023 11:34 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:JUAREZ, LILIA FAMILY CHILD CAREFACILITY NUMBER:
153905169
ADMINISTRATOR:JUAREZ, LILIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(661) 854-2085
CITY:ARVINSTATE: CAZIP CODE:
93203
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: DATE:
03/08/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:29 AM
MET WITH:TIME COMPLETED:
11:03 AM
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On 03/08/23 LPA Beneroso attempted to conduct an annual inspection but was unsuccessful due to the licensee being closed until Tuesday, March 14.
LPA spoke with licensee on the phone and went over the requirements for the annual inspections.

LPA would attempt a second inspection later this month.
SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Barbara Beneroso
LICENSING EVALUATOR SIGNATURE: DATE: 03/08/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/08/2023
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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