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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364841832
Report Date: 07/22/2019
Date Signed: 07/22/2019 10:03:14 AM

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:TYSON FAMILY CHILD CAREFACILITY NUMBER:
364841832
ADMINISTRATOR:TYSON,LINDAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(760) 843-2925
CITY:VICTORVILLESTATE: CAZIP CODE:
92394
CAPACITY:14CENSUS: 9DATE:
07/22/2019
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
09:44 AM
MET WITH:Linda TysonTIME COMPLETED:
10:18 AM
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Licensing Program Analyst (LPA Thompson-Miller met with Licensee, Linda Tyson, for a Case Management - Other Inspection. Upon arrival LPA observed 9 day care children (two infants, four school age and 3 preschool) along with two assistants and Licensee.

The purpose of the inspection is to review and discuss exemption approval for additional adult associated and cleared to the facility.

LPA Thompson-Miller reviewed the following with Licensee regarding Tia Johnson:
--The individual does not violate any licensing laws or regulation
--The individual does not engage in conduct that indicates that he/she may pose a risk to the health and safety of any individual who is or may be a client.
--The individual does not fail to disclose a conviction even if it occurred before the exemption was granted.
--The individual is not convicted of a subsequent crime.

Licensee has been aware that criminal record exemptions are public information.

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

DATE: 07/22/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/22/2019
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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