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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 367750046
Report Date: 11/06/2023
Date Signed: 11/06/2023 03:13:33 PM

Document Has Been Signed on 11/06/2023 03:13 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:AZY'S PLACE CHILDRENS CENTERFACILITY NUMBER:
367750046
ADMINISTRATOR:SALEENA SMITHFACILITY TYPE:
840
ADDRESS:58967 BUSINESS CENTER DR STE GTELEPHONE:
(760) 228-9068
CITY:YUCCA VALLEYSTATE: CAZIP CODE:
92284
CAPACITY: 25TOTAL ENROLLED CHILDREN: 2CENSUS: 0DATE:
11/06/2023
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
02:50 PM
MET WITH:Administrator Saleena Smith TIME COMPLETED:
03:20 PM
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On November 6, 2023, at 2:50 p.m., Licensing Program Analyst (LPA) Kendal Zirbes conducted an unannounced Plan of Correction (POC) inspection and met with Administrator Saleena Smith. LPA disclosed the purpose of the inspection and was granted entry into the facility by the Administrator. Zero children were present during this inspection.

During this inspection, LPA and Administrator completed a tour of the facility at approximately 02:55 p.m.. LPA observed the following:
1. Facility was within the licensed capacity and supervision requirements were being met.


Based on LPAs record review and observations, the citation issued on November 1, 2023, have been corrected.

A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the Administrator Saleena Smith.
SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Kendal Zirbes
LICENSING EVALUATOR SIGNATURE: DATE: 11/06/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/06/2023
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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