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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 153908253
Report Date: 07/18/2022
Date Signed: 07/18/2022 04:51:05 PM


Document Has Been Signed on 07/18/2022 04:51 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
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551



FACILITY NAME:WALLACE, CAREN FAMILY CHILD CAREFACILITY NUMBER:
153908253
ADMINISTRATOR:WALLACE, CARENFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(661) 599-5900
CITY:TEHACHAPISTATE: CAZIP CODE:
93561
CAPACITY:14CENSUS: 0DATE:
07/18/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:21 AM
MET WITH:Caren WallaceTIME COMPLETED:
10:05 AM
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 On 07/18/2022, at 09:21 a.m. Licensing Program Analysts (LPA) Esequiel Rodriguez conducted an unannounced annual inspection at the Family Child Care Home to assess the Facility operation of their program and current physical plant status. Also, to evaluate the Facility's continuing ability to meet compliance with California Code of Regulations (CCR) Title 22, Health and Safety requirements, and other applicable State and Licensing Statutory requirements. LPA Rodriguez knock at the door, but no one answered. The LPA called the listed phone number and spoke to Ms. Wallace. She stated the facility is no longer providing child care services, and that she was in the process of relocation. She said that she was not sure if she wanted to continue to provide child care services.

LPA explained that licenses are not transferable and if she wanted to continue to provide child care, she would have to reapply again. The LPA explained proper relocation protocols per Title 22 and to submit a letter to keep in record indicating she notified the Department about her relocation.

Ms Wallece asked to go ahead and close her facility. She will send the request for closure thereafter.

LPA will proceeded with the closure of this facility.

This report was created for record purposes. Licensee was not available for signature.
SUPERVISOR'S NAME: Scott HerringTELEPHONE: (661) 202-3314
LICENSING EVALUATOR NAME: Esequiel RodriguezTELEPHONE: (661) 202-3321
LICENSING EVALUATOR SIGNATURE:
DATE: 07/18/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/18/2022
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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