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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197414043
Report Date: 09/18/2024
Date Signed: 09/18/2024 03:50:05 PM

Document Has Been Signed on 09/18/2024 03:50 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:CCRC HEAD START-MIGUEL MONTESFACILITY NUMBER:
197414043
ADMINISTRATOR/
DIRECTOR:		HERMINEH AZIZIANFACILITY TYPE:
850
ADDRESS:10675 TELFAIR STREETTELEPHONE:
(818) 834-2358
CITY:PACOIMASTATE: CAZIP CODE:
91331
CAPACITY: 39TOTAL ENROLLED CHILDREN: 39CENSUS: 9DATE:
09/18/2024
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
03:16 PM
MET WITH:Celia Cassio, EECB SupervisorTIME VISIT/
INSPECTION COMPLETED:
04:00 PM
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On 9/18/2024, Licensing Program Analysts(LPAs) Isabel Ortega and Donna Maddox arrived at the facility, LPAs announced the purpose of today's inspection and was granted entry. Upon arrival LPAs observed 9 children in care 4 Staff providing care and supervision. Classroom #1 is utilized for preschool children ages 2 year to 5 year olds.
Today's Case Management inspection was initiated by facility. Facility has requested to add a Toddler component option, therefore a decrease of capacity has been assessed in the preschool license. Facility has 3 sinks and 3 toilets available for children.
Due to new regulations this facility will be closed and a new single license shall be issued with effective 9/19/2024, new License number will be 197750192(Toddler option classroom #2).
Classroom #1 Measures:
34.09 square feet x 21 = 715.89 dived by 35 = 20 children
The outdoor space measures square feet: 4171.25 -1250(toddler space)= 2,921 divided by 75 = total number of 39 children.

Facility is in compliance and has met Title 22 regulations.
An exit interview was conducted and a copy of this report, appeal rights and Notice of Site Visit (NOA) was provided to the facility on this date. A copy of this report must be made available to the public for 3 years. NOA shall be posted for 30 days.
SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Isabel Ortega
LICENSING EVALUATOR SIGNATURE: DATE: 09/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/18/2024
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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