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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364804617
Report Date: 05/11/2023
Date Signed: 05/11/2023 11:43:39 AM


COMPREHENSIVE INSPECTION

Document Has Been Signed on 05/11/2023 11:43 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551



FACILITY NAME:HOOK FAMILY CHILD CAREFACILITY NUMBER:
364804617
ADMINISTRATOR:HOOK, CYNTHIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(760) 242-5104
CITY:APPLE VALLEYSTATE: CAZIP CODE:
92307
CAPACITY:14CENSUS: 0DATE:
05/11/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:HOOK CYNTHIATIME COMPLETED:
11:23 AM
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Licensing Program Analyst (LPA) Babatunde Ibitoye met with license Cynthia Hook. The purpose of the inspection is to conduct a Required 1 year Annual inspection. Licensee is license to provide care and supervision for a Large Family Child Care home for the capacity of 14 children. There are currently (0) children enrolled in the family child care. Present during the time of this inspection is licensee and spouse.

Per Licensee they are on there way out and she don't have any children in care since Covid 19 and further stated she is no longer interested in day-care. Per Licensee she will surrender her License with a letter to Palmdale Regional Office by 5/12/2023.


Exit.
SUPERVISOR'S NAME: Claretta YatesTELEPHONE: (661) 789-6944
LICENSING EVALUATOR NAME: Babatunde IbitoyeTELEPHONE: 661-568-8179
LICENSING EVALUATOR SIGNATURE:
DATE: 05/11/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/11/2023
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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