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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197419664
Report Date: 10/09/2019
Date Signed: 10/09/2019 05:10:26 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1605 EAST PALMDALE BLV, STE A
PALMDALE, CA 93550
FACILITY NAME:KIDS' CORNER PRESCHOOLFACILITY NUMBER:
197419664
ADMINISTRATOR:ANNA FISHERFACILITY TYPE:
850
ADDRESS:4020 LANCASTER BLVD.TELEPHONE:
(661) 946-4668
CITY:LANCASTERSTATE: CAZIP CODE:
93535
CAPACITY:67CENSUS: 46DATE:
10/09/2019
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
04:30 PM
MET WITH:Anna Fisher, DirectorTIME COMPLETED:
05:15 PM
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Licensing Program Analyst (LPA) Maddox met with Director, Anna Fisher today for the purpose of conducting a Case Management inspection. Center has requested to add another classroom for the Toddler Option. Currently there is 1 Toddler classroom (Rm #107) which is licensed for 13. Today, LPA measured Rm # 101 today which also has a bathroom inside with 1 toilet, 1 sink, and 1 diaper changing Koala Care table. Today measurements were as follows:

19 X 21 = 432/35 equals 12

Fire Clearance has been received to add the classroom, changing the total capacity to 79 (54 Preschool children and 25 Toddlers).

Center now occupies Room #'s 101, 103 thru 107.
SUPERVISOR'S NAME: Mariela RamonTELEPHONE: (661) 789-6952
LICENSING EVALUATOR NAME: Donna MaddoxTELEPHONE: (661) 568-8971
LICENSING EVALUATOR SIGNATURE:

DATE: 10/09/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/09/2019
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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