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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198019270
Report Date: 12/12/2022
Date Signed: 12/12/2022 10:32:37 AM

Document Has Been Signed on 12/12/2022 10:32 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, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:PALMER FAMILY CHILD CAREFACILITY NUMBER:
198019270
ADMINISTRATOR:KELSIE & VICTORIA PALMERFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(323) 427-1437
CITY:PARAMOUNTSTATE: CAZIP CODE:
90723
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 5DATE:
12/12/2022
TYPE OF VISIT:Case Management - Legal/Non-complianceUNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Victoria Palmer & Kelsie Palmer, LicenseesTIME COMPLETED:
10:50 AM
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On 12/12/22, Licensing Program Analysts (LPAs) Susann Sanchez & Austin Estrada, conducted an unannounced Case Management-Legal/Non-compliance Inspection. LPAs met with Licensee Kelsie Palmer and Victoria Palmer. The purpose for today's inspection is to ensure that the licensee are operating in full compliance following the Decision & Ordered- CDSS No. 7922255008B that became effective on today's date 12/12/22.

There was 3 children, 2 infants, 1 assistant, 1 adult (that lives in the home), present with Licensees when LPAs arrived. LPAs toured facility including off limit areas. Pictures were taken.

LPAs observed the following:
  • LPAs reviewed all individuals residing or working in the home have been discussed.
  • All adults present during today's inspection in the home have obtained a criminal record clearance.
  • Previous uncleared adult items have been removed from the home.


Consult was given at 10:16am regarding fingerprints and application updates.

The Notice of Site Visit (LIC 9213) – must remain posted for 30 days during the hours of operation after each site visit made by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00 No deficiencies cited. Exit interview was conducted with Licensee Victoria Palmer. Appeal Rights were given and explained.
SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Susann Sanchez
LICENSING EVALUATOR SIGNATURE: DATE: 12/12/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/12/2022
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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