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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197750082
Report Date: 06/28/2021
Date Signed: 06/28/2021 03:47:23 PM

Document Has Been Signed on 06/28/2021 03:47 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
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME:TINKER VILLAGEFACILITY NUMBER:
197750082
ADMINISTRATOR:ERICKA DIAZFACILITY TYPE:
850
ADDRESS:41955 50TH STREET WEST #103TELEPHONE:
(661) 718-3081
CITY:QUARTZ HILLSSTATE: CAZIP CODE:
93536
CAPACITY: 30TOTAL ENROLLED CHILDREN: 0CENSUS: 11DATE:
06/28/2021
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
03:15 PM
MET WITH:Ericka DiazTIME COMPLETED:
04:00 PM
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Licensing Program Analyst (LPA) Maddox met with Owner, Ericka Diaz today for the purpose of conducting an unannounced Case Management inspection.

On 5/4/2021, Owner was cited for having School age children present without having a School age license. Owner's POC was to have the School age children go to her licensed FCCH (X 197415024) where her daughter is a co- licensee.

During todays inspection, LPA observed the following: there were 11 Preschool age children present with 2 teachers. Center was operating within the terms of their license today.

SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Donna Maddox
LICENSING EVALUATOR SIGNATURE: DATE: 06/28/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/28/2021
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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