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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 360910831
Report Date: 01/28/2025
Date Signed: 01/28/2025 11:51:51 AM

Document Has Been Signed on 01/28/2025 11:51 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 CC RO, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME:PSD/APPLE VALLEY HEAD STARTFACILITY NUMBER:
360910831
ADMINISTRATOR/
DIRECTOR:		MAGDALENA LOZANOFACILITY TYPE:
850
ADDRESS:13589 NAVAJO ROADTELEPHONE:
(760) 247-6955
CITY:APPLE VALLEYSTATE: CAZIP CODE:
92308
CAPACITY: 117TOTAL ENROLLED CHILDREN: 117CENSUS: 49DATE:
01/28/2025
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:30 AM
MET WITH:MAGDALENA LOZANOTIME VISIT/
INSPECTION COMPLETED:
12:00 PM
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On January 28th 2025, at 09:30 a.m., Licensing Program Analyst (LPA's) Braddock and Cha met with acting site supervisor Magdalena Lozano. The purpose of the inspection was to conduct an unannounced case management inspection at the licensed facility for the Unusual Incident Report received at the Palmdale Regional Office on 1/16/25. LPA disclosed the purpose of the inspection. When LPA's arrived to the facility, there were Thirteen (13) staff providing supervision to Forty nine (49) children.

During the inspection, LPA's conducted confidential interviews with staff and children in care and completed a safety tour of the facility.

Based on LPAs observations no future investigation is needed.

A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100. Exit interview conducted and report was reviewed with the Licensee.

SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Sherell Braddock
LICENSING EVALUATOR SIGNATURE: DATE: 01/28/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/28/2025
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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