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Department of
SOCIAL SERVICES
Community Care Licensing
FACILITY EVALUATION REPORT
Facility Number:
153907305
Report Date:
11/03/2022
Date Signed:
11/03/2022 12:15:44 PM
COMPREHENSIVE INSPECTION
Document Has Been Signed on
11/03/2022 12:15 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:
GARCIA FAMILY CHILD CARE
FACILITY NUMBER:
153907305
ADMINISTRATOR:
GARCIA, LOURDES
FACILITY TYPE:
810
ADDRESS:
TELEPHONE:
(661) 770-8555
CITY:
ARVIN
STATE:
CA
ZIP CODE:
93203
CAPACITY:
14
TOTAL ENROLLED CHILDREN:
14
CENSUS:
DATE:
11/03/2022
TYPE OF VISIT:
Required - 1 Year
UNANNOUNCED
TIME BEGAN:
12:00 PM
MET WITH:
TIME COMPLETED:
12:14 PM
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SUPERVISORS NAME
:
Mariela Ramon
LICENSING EVALUATOR NAME
:
Barbara Beneroso
LICENSING EVALUATOR SIGNATURE
:
DATE:
11/03/2022
I acknowledge receipt of this form and understand my
licensing
appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
11/03/2022
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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