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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197700191
Report Date: 05/22/2019
Date Signed: 05/22/2019 04:23:06 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:DUNN, RODEEN FAMILY CHILD CAREFACILITY NUMBER:
197700191
ADMINISTRATOR:DUNN, RODEENFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(661) 878-6794
CITY:PALMDALESTATE: CAZIP CODE:
93551
CAPACITY:14CENSUS: 10DATE:
05/22/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
01:57 PM
MET WITH:Rodeen DunnTIME COMPLETED:
04:47 PM
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Licensing Program Analyst (LPA) Victoria Hunt met with Priyangika Edirisingha, who stated that she was a teacher at the home. Priyangika Edirisngha guided analyst on a tour of the facility for an annual random inspection. Upon arrival at the facility the licensee was not present per, Ms. Priyangika Edirisingha the licensee was performing pick ups. There were three other adults staff members who were present at the facility in the home that were assisting children. All adults were associated to the facility. During the time of this inspection licensee had ten children in care.

During today's inspection LPA reviewed children's and staff records. Due to time constraints LPA was not able to complete a tour of the facility. LPA will return to the facility to complete a full inspection.

SUPERVISOR'S NAME: Mariela RamonTELEPHONE: (661) 789-6952
LICENSING EVALUATOR NAME: Victoria HuntTELEPHONE: (661) 568-8930
LICENSING EVALUATOR SIGNATURE:

DATE: 05/22/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/22/2019
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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