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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197415077
Report Date: 02/14/2024
Date Signed: 02/14/2024 03:25:32 PM


Document Has Been Signed on 02/14/2024 03:25 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 CC RO, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551



FACILITY NAME:FAHAR FAMILY CHILD CAREFACILITY NUMBER:
197415077
ADMINISTRATOR:FAHAR, REBAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(661) 259-2966
CITY:SANTA CLARITASTATE: CAZIP CODE:
91350
CAPACITY:14CENSUS: 11DATE:
02/14/2024
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
03:15 PM
MET WITH:Reba Fahar, LicenseeTIME COMPLETED:
03:45 PM
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On Wednesday, February 14, 2024 Licensing Program Analyst (LPA) Mayra Rivera conducted an unannounced case management inspection and met with licensee Reba Fahar. LPA observed 11 children present (4 infants and 7 preschool) with two assistants present. During this visit, LPA Rivera reviewed the plan of correction and observed licensees AB 1207 Child Abuse Mandated Reporting Certificate dated 4/3/2023 and assistant dated 4/2/2023. LPA Rivera cleared the Type B citation.

A notice of site visit was given and must remain posted for 30 days.

An exit interview was conducted, during which this report and the Appeal Rights were discussed with licensee Reba Fahar.

SUPERVISOR'S NAME: Lady KingTELEPHONE: (661) 202-3318
LICENSING EVALUATOR NAME: Mayra RiveraTELEPHONE: (661) 603-1090
LICENSING EVALUATOR SIGNATURE:
DATE: 02/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/14/2024
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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