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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 153908258
Report Date: 10/17/2022
Date Signed: 10/17/2022 05:19:16 PM


Document Has Been Signed on 10/17/2022 05:19 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:LUCAS, TONYA FAMILY CHILD CAREFACILITY NUMBER:
153908258
ADMINISTRATOR:LUCAS, TONYAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(760) 793-8112
CITY:RIDGECRESTSTATE: CAZIP CODE:
93555
CAPACITY:14CENSUS: 5DATE:
10/17/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
04:46 PM
MET WITH:Tonya LucasTIME COMPLETED:
05:25 PM
NARRATIVE
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On 10/17/2022 Licensing Program Analyst (LPA) Isabel Ortega conducted an unannounced Case Management to the Lucas Family Child Care (FCC) home. During the inspection licensee was not able to provide LPA with a Children Roster. Licensee states she does not have a current roster and can not locate the roster. Present during the inspection are licensees, licensees Assistant and 5 children.

Exit interview conducted, a copy of this report, appeal rights and notice of site visit was provided to licensee Tonya Lucas.
SUPERVISOR'S NAME: Lady KingTELEPHONE: (310) 568-1824
LICENSING EVALUATOR NAME: Isabel OrtegaTELEPHONE: (661) 202-3786
LICENSING EVALUATOR SIGNATURE:
DATE: 10/17/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/17/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 2


Document Has Been Signed on 10/17/2022 05:19 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551


FACILITY NAME: LUCAS, TONYA FAMILY CHILD CARE
FACILITY NUMBER: 153908258

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/17/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
10/24/2022
Section Cited

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Operation of a Family Child Care Home. All homes shall have a current roster of the children. Each child day care facility shall maintain a current roster of children who are
provided care in the facility roster shall be available to the licensing agency upon request. This requirement is not met as evidenced by:
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Statement from licensee stating she does not have the facility children roster and LPA did not observe a Children Roster. This poses a potential risk to children in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Lady KingTELEPHONE: (310) 568-1824
LICENSING EVALUATOR NAME: Isabel OrtegaTELEPHONE: (661) 202-3786
LICENSING EVALUATOR SIGNATURE:
DATE: 10/17/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/17/2022
LIC809 (FAS) - (06/04)
Page: 2 of 2