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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191611228
Report Date: 07/03/2019
Date Signed: 07/03/2019 02:21:03 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:PALAZZOLO FAMILY DAY CAREFACILITY NUMBER:
191611228
ADMINISTRATOR:NOEMI PALAZZOLOFACILITY TYPE:
810
ADDRESS:TELEPHONE:
3108361978
CITY:CULVER CITYSTATE: CAZIP CODE:
90232
CAPACITY:12CENSUS: 7DATE:
07/03/2019
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
01:15 PM
MET WITH:Noemi Palazzolo, Licensee and licensee's husband(assistant)TIME COMPLETED:
02:25 PM
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Licensing Program Analysts Denise Miranda conducted an unannounced Case Management Inspection for the purpose of a Plan Of Correction (POC). At 1:15 PM LPAs met with licensee Noemi Palazzolo and licensee’s husband as her assistant.

On 05/30/2019 Staffing ratio – licensee had 9 children in care (which five were infants) and 6/7/2019 – staffing ratio – licensee had 9 children (which six were infants).

On 07/3/2019, at 1:30 PM during the inspection LPA observed 7 children in care sleeping, which 3 were infants. Licensee and Licensee’s husband were providing care and supervision.
Facility was of ratio and in compliance with the terms and conditions of the facility license.
On 7/3/2019 at 1:49pm LPA reviewed the seven children’s file and sign in/out form.

During this visit LPA provided an original license showing Ms. Noemi Palazzolo as a licensee. Licensee returned to LPA her previous license that was showing Ms. Noemi as a co-licensee.

An exit interview was conducted and a copy of this report was given to licensee Noemi Palazzolo
SUPERVISOR'S NAME: Jennie FerreiraTELEPHONE: (424) 301-3067
LICENSING EVALUATOR NAME: Denise MirandaTELEPHONE: (424) 301-3055
LICENSING EVALUATOR SIGNATURE:

DATE: 07/03/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/03/2019
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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