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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 157700112
Report Date: 03/05/2024
Date Signed: 03/06/2024 09:16:52 AM

Document Has Been Signed on 03/06/2024 09:16 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:DIAZ FAMILY CHILD CAREFACILITY NUMBER:
157700112
ADMINISTRATOR:DIAZ, MARIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(661) 436-3646
CITY:ARVINSTATE: CAZIP CODE:
93203
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 7DATE:
03/05/2024
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
01:28 PM
MET WITH:Maria Diaz TIME COMPLETED:
02:30 PM
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On March 5, 2024, at 01:38 p.m., Licensing Program Analyst (LPA) Beneroso conducted an unannounced Plan of Correction (POC) inspection and met with Licensee Maria Diaz. LPA disclosed the purpose of the inspection and was granted entry into the facility by the Licensee. A total of 7 children were present at the facility. The Licensee and one assistant was present and providing supervision.

During this inspection, LPA completed a tour of the facility and observed the following:
1. Form LIC9227 and Sleep Logs for Infants were completed.
2. Assistant’s vaccine record were observed to be complete
3. Consent to Emergency Medical Care was observed to be complete for all children
4. Fire Drill Documentation was

Based on LPA’s observations and record review, the citations issued on 2/15/24 were corrected.

A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the Licensee Maria Diaz
SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Barbara Beneroso
LICENSING EVALUATOR SIGNATURE: DATE: 03/05/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/05/2024
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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