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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364842256
Report Date: 08/09/2019
Date Signed: 08/09/2019 01:30:49 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:GUZMAN FAMILY CHILD CAREFACILITY NUMBER:
364842256
ADMINISTRATOR:GUZMAN, BRENDAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(760) 550-7606
CITY:HESPERIASTATE: CAZIP CODE:
92345
CAPACITY:14CENSUS: 7DATE:
08/09/2019
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
12:08 PM
MET WITH:Brenda GuzmanTIME COMPLETED:
01:43 PM
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Licensing Program Analyst (LPA) Thompson-Miller met with Licensee, Brenda Guzman, for a Case Management - Incident Inspection. Incident report dated August 5, 2019. The incident occurred on August 1, 2019. Present are licensee and licensee assistant (spouse). There are two infants and five toddlers/preschool children.

Description of the incident: Child #1 exhibited behavior of curiosity by touching her genital (private) area, during nap time. Licensee (Staff #1) observed Child #1 during nap time touching private area and immediately asked Child #1 to stop touching in which Child #1 did stop. Licensee reported unusual behavior of child to authorized representative (parent-mother) and child service agencies. Child #1 and Parent #1 no longer attend the facility as of August 4, 2019. Interview conducted with licensee during the inspection. Licensee followed proper protocol regarding the incident.

Based on information provided and interviews conducted the incident does not appear to have been the result of any violation of the Title 22 regulation, therefore no deficiencies were cited. Exit interview conducted and a copy of report provided to Licensee, Brenda Guzman on this day.
SUPERVISOR'S NAME: Carissa BellTELEPHONE: (661) 789-6953
LICENSING EVALUATOR NAME: Linda Thompson-MillerTELEPHONE: (661) 568-8186
LICENSING EVALUATOR SIGNATURE:

DATE: 08/09/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/09/2019
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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