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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 367700328
Report Date: 05/17/2023
Date Signed: 05/17/2023 01:15:23 PM

Document Has Been Signed on 05/17/2023 01:15 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:BRAVO & HERNANDEZ FAMILY CHILD CAREFACILITY NUMBER:
367700328
ADMINISTRATOR:ANA BRAVO & HUGO HERNANDEZFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(619) 648-7218
CITY:VICTORVILLESTATE: CAZIP CODE:
92394
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 2DATE:
05/17/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
12:54 PM
MET WITH:Hugo Hernandez, LicenseeTIME COMPLETED:
01:15 PM
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On May 17, 2023, Licensing Program Analyst (LPA), Kuliema Calloway made an unannounced case management inspection to Bravo/Hernandez Family Child Care. LPA met with S2 who granted access. The purpose of the visit was to interview the Licensee, regarding allegations that were received in Palmdale Regional Office regarding Child 1. LPA toured the home with the licensee.

LPA observed 2 kids in care that were not day care children. There are two adults inside the home. LPA conducted an interview. There was no facility roster since there are no day care children currently inside the home.

An exit interview was conducted and a copy of this report, and a Notice of Site Visit, were left with S1 at the facility.
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Kuliema Calloway
LICENSING EVALUATOR SIGNATURE: DATE: 05/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/17/2023
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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