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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197414500
Report Date: 11/23/2022
Date Signed: 11/23/2022 02:09:32 PM


Document Has Been Signed on 11/23/2022 02:09 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:AYALA FAMILY CHILD CAREFACILITY NUMBER:
197414500
ADMINISTRATOR:AYALA, L.FACILITY TYPE:
810
ADDRESS:TELEPHONE:
(818) 782-6125
CITY:ARLETASTATE: CAZIP CODE:
91331
CAPACITY:14CENSUS: 7DATE:
11/23/2022
TYPE OF VISIT:Case Management - Health ChecksUNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Loreto AyalaTIME COMPLETED:
02:38 PM
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On 11/23/2022 Licensing Program Analyst (LPA) Isabel Ortega met with licensee, Loreto Ayalya today for the purpose of conducting an unannounced Case Management Health check- inspection. This Case Management inspection is conducted to review and remove Licensee from probation status (completed term). Upon arrival LPA observed 7 children in care and 2 staff.

Licensee shall operate the facility in strict compliance with the regulations and statutes governing the operation of a child care facility. The operational child care hours are Monday through Saturday 23 hours depending on family's need.

During the period of probation, the Department in its sole discretion and may conduct unannounced site inspections for the purpose of determining whether there is full compliance with the regulations and statutes governing the operation of a child care facility. Licensee has completed the probation term and is in compliance for Title 22.
SUPERVISOR'S NAME: Lady KingTELEPHONE: (310) 568-1824
LICENSING EVALUATOR NAME: Isabel OrtegaTELEPHONE: (661) 202-3786
LICENSING EVALUATOR SIGNATURE:
DATE: 11/23/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/23/2022
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


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: AYALA FAMILY CHILD CARE
FACILITY NUMBER: 197414500
VISIT DATE: 11/23/2022
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Licensee shall ensure that all individuals working, residing, or volunteering in the facility shall obtain criminal record clearances or exemptions prior to their initial presence in the facility and shall maintain proof of such criminal record clearances or exemptions at the facility.
Each child receiving services from a family child care home shall have certain rights that shall not be waived or abridged by the licensee regardless of consent or authorization from the child's authorized representative. These rights include, but are not limited to, the following...To be treated with dignity in his/her personal relationship with staff and other personal... During inspection LPA observed licensee approach children in a gentle and a calm voice. LPA observed positive child and licensee interaction.

Licensee shall maintain current personnel records of each employee at the facility and ensure that all employees have a current certificate of CPR and First aid training on file at the facility. Licensee’s Child Care Provider Mandated Reporter training (AB1207)certification is dated 6/16/2021 and CPR/First Aid is current expires 08/04/2023.

Licensee is required to maintain an accurate, complete, and current client roster which must be made available to the Department upon request.

An exit interview was conducted with licensee Loreto Ayala. A copy of this report along with notice of site visit were provided.
SUPERVISOR'S NAME: Lady KingTELEPHONE: (310) 568-1824
LICENSING EVALUATOR NAME: Isabel OrtegaTELEPHONE: (661) 202-3786
LICENSING EVALUATOR SIGNATURE:

DATE: 11/23/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/23/2022
LIC809 (FAS) - (06/04)
Page: 2 of 2