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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364813599
Report Date: 10/28/2022
Date Signed: 10/28/2022 01:13:21 PM


Document Has Been Signed on 10/28/2022 01:13 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
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551



FACILITY NAME:APPLE VALLEY CHILD CARE CENTERFACILITY NUMBER:
364813599
ADMINISTRATOR:SHERRY JENKINSFACILITY TYPE:
850
ADDRESS:18609 CORWIN ROADTELEPHONE:
(760) 242-5437
CITY:APPLE VALLEYSTATE: CAZIP CODE:
92307
CAPACITY:72CENSUS: 31DATE:
10/28/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:52 AM
MET WITH:SHERRY JENKINSTIME COMPLETED:
01:15 PM
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Licensing Program Analysts LPA Ibitoye met with Sherry Jenkins Center Director, today for the purpose of conducting a required 1 year unannounced Annual inspection for the Pre-School. During the cause of Annual Inspection it was disclosed the facility is no longer operating due to change of ownership. Further information is needed. LPA get a declaration from the Director stating the Facility is under the new owner.
SUPERVISOR'S NAME: Claretta YatesTELEPHONE: (661) 789-6944
LICENSING EVALUATOR NAME: Babatunde IbitoyeTELEPHONE: 661-568-8179
LICENSING EVALUATOR SIGNATURE:
DATE: 10/28/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/28/2022
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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