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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 153907305
Report Date: 11/03/2022
Date Signed: 11/03/2022 12:15:44 PM


COMPREHENSIVE INSPECTION

Document Has Been Signed on 11/03/2022 12:15 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:GARCIA FAMILY CHILD CAREFACILITY NUMBER:
153907305
ADMINISTRATOR:GARCIA, LOURDESFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(661) 770-8555
CITY:ARVINSTATE: CAZIP CODE:
93203
CAPACITY:14CENSUS: DATE:
11/03/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:TIME COMPLETED:
12:14 PM
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SUPERVISOR'S NAME: Mariela RamonTELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Barbara BenerosoTELEPHONE: (661) 202-3411
LICENSING EVALUATOR SIGNATURE:
DATE: 11/03/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/03/2022
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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