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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364841487
Report Date: 06/26/2019
Date Signed: 06/26/2019 04:39:35 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:COLLIER FAMILY CHILD CAREFACILITY NUMBER:
364841487
ADMINISTRATOR:COLLIER, CHRISTINAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(760) 221-8543
CITY:ADELANTOSTATE: CAZIP CODE:
92301
CAPACITY:14CENSUS: 5DATE:
06/26/2019
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
03:45 PM
MET WITH:Christina CollierTIME COMPLETED:
04:44 PM
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Licensing Program Analyst's (LPAs) Thompson-Miller and Smith met with Licensee, Christina Collier and spouse (Dante Collier) for a Case Management Other inspection. The purpose of the inspection is to verify above ground pool has been drained (photos were also submitted of the pool drained).

Licensee will submit additional photos of the backyard (left side off limits where above ground pool is located and right side which is the child care play area) for clarification of fencing requirements.

Exit interview conducted and a copy of report was read and issued to Licensee, Christina Collier on this date.
SUPERVISOR'S NAME: Carissa BellTELEPHONE: (661) 789-6953
LICENSING EVALUATOR NAME: Linda Thompson-MillerTELEPHONE: (661) 568-8186
LICENSING EVALUATOR SIGNATURE:

DATE: 06/26/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/26/2019
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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