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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197700491
Report Date: 06/22/2021
Date Signed: 06/22/2021 09:47:32 AM

Document Has Been Signed on 06/22/2021 09:47 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
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME:MAJUAN FAMILY CHILD CAREFACILITY NUMBER:
197700491
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 0CENSUS: 1DATE:
06/22/2021
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
09:40 AM
MET WITH:Maidelin Majuan, ApplicantTIME COMPLETED:
10:30 AM
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On June 22, 2021 at 9:40 AM Licensing Program Analyst (LPA) Monique Ayala conducted a tele-visit follow up Prelicensing Inspection for Majuan Family Child Care Home. LPA with applicant Maidelin Majuan, who guided the LPA on a tour of the home. All adults residing in the home are fingerprint cleared and associated to the facility.

During the pre-licensing inspection conducted on 06/16/2021, the following corrections were required:
- Swimming Pool must meet Title 22 Regulations, swimming pool gate on the left side was 4 feet tall due to a step that decreased the measurement of 5 feet.

During today's inspection the following corrections were observed:
- LPA observed the swimming pool gate is now 5 feet tall and meets Title 22 Regulations.

Facility is ready for licensure.

An exit interview was conducted and a copy of this report was provided to the applicant via email on 06/22/2021.
SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Monique Jessica Ayala
LICENSING EVALUATOR SIGNATURE: DATE: 06/22/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/22/2021
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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