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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 367700354
Report Date: 08/30/2023
Date Signed: 08/30/2023 11:39:45 AM

Document Has Been Signed on 08/30/2023 11:39 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 CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME:RUIZ FAMILY CHILD CAREFACILITY NUMBER:
367700354
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 0DATE:
08/30/2023
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Maria Ruiz, ApplicantTIME COMPLETED:
12:00 PM
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On August 30, 2023, Licensing Program Analyst (LPA), Kuliema Calloway conducted a follow up Pre-Licensing Inspection to Ruiz Family Child Care. LPA met with the Applicant who granted access.

LPA and Applicant toured the home inside and outside and observed the Pet vaccinations, AC Unit (covered), Smoke Alarms (operable) and the relocation of the Fire Extinguisher inside the day care area.

Applicant was given the Pre-Licensing packet with licensing forms.

As a result of this inspection, Applicant was informed the childcare license is pending LPM approval.

Exit interview conducted: A copy of this report was read, a Notice of Site Visit were discussed and left with Maria Ruiz, Applicant. The Notice of Site Visit shall be posted for thirty (30) consecutive days.

SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Kuliema Calloway
LICENSING EVALUATOR SIGNATURE: DATE: 08/30/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/30/2023
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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