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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364842256
Report Date: 04/06/2021
Date Signed: 04/06/2021 01:56:49 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
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:
04/06/2021
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Brenda GuzmanTIME COMPLETED:
01:28 PM
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Licensing Program Analyst (LPA) Thompson-Miller met with Licensee, Brenda Guzman, for a Case Management - Incident Inspection. Inspection conducted virtual due to COVID-19. Incident report dated March 29, 2021. The incident occurred on March 29, 2021. Present are licensee and licensee assistant (spouse). There are seven children present.

Description of the incident: Child in care alleged inappropriate touch by staff
Interviews were conducted with licensee, licensee spouse, parent and child. Child and sibling continue to attend the facility. Licensee followed proper protocol regarding the incident. Investigation pending other agency investigation.

Based on information provided and interviews conducted the incident requires additional investigation. Exit interview conducted and a copy of this report will be emailed to Licensee Brenda Guzman (due to COVID-19). The read receipt is in lieu of a signature.
SUPERVISOR'S NAME: Claretta YatesTELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Linda Thompson-MillerTELEPHONE: (661) 568-8186
LICENSING EVALUATOR SIGNATURE:

DATE: 04/06/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/06/2021
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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