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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191202079
Report Date: 01/23/2024
Date Signed: 01/23/2024 01:02:01 PM


Document Has Been Signed on 01/23/2024 01:02 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:SMALL WORLD NURSERYFACILITY NUMBER:
191202079
ADMINISTRATOR:MILLER, LINDAFACILITY TYPE:
850
ADDRESS:26640 NORTH BOUQUET CANYON RDTELEPHONE:
(661) 296-1155
CITY:SAUGUSSTATE: CAZIP CODE:
91350
CAPACITY:85CENSUS: 10DATE:
01/23/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Michelle Moyer, DirectorTIME COMPLETED:
11:45 AM
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On 1/23/2024 Licensing Program Analyst (LPA) Ortega conducted an unannounced Case Management - Other site inspection. Upon arrival LPA met with facility Director, Michelle Moyer and toured the facility.
LPA announced the purpose of today's inspection and was granted entry. Upon arrival LPA observed 10 children in care and 3 staff providing care and supervision.

The purpose of today's inspection was to amend report findings dated on 03/30/2023 regarding complaint investigation report (LIC9099).

The findings report was amended correcting error regarding facility's physical plant room #6 was damaged by the water and an odor was detected while day care children and staff were present dated 3/30/2023.


An exit Interview was conducted, a copy of this Report, Notice of Site visit, and the amended report was provided to Director, Michelle Moyer.
SUPERVISOR'S NAME: Lady KingTELEPHONE: (310) 568-1824
LICENSING EVALUATOR NAME: Isabel OrtegaTELEPHONE: (661) 202-3786
LICENSING EVALUATOR SIGNATURE:
DATE: 01/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/23/2024
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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