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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 367700040
Report Date: 06/23/2020
Date Signed: 06/23/2020 03:55:20 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:VALDEPENA FAMILY CHILD CAREFACILITY NUMBER:
367700040
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: DATE:
06/23/2020
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
03:24 PM
MET WITH:Guendolyn Valdepena TIME COMPLETED:
03:54 PM
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Licensing Program Analyst (LPA) Hunt contacted licensee Guendolyn Valdepena for the purpose of a case management inspection, a modification to the facility plant. This inspection was conducted remotely due to COVI9- Emergency Response. The licensee made modifications to the backyard are by adding an above ground pool.

During today’s inspection the fence surrounding the above ground pool was inspected to ensure it meets regulations. The fencing surrounding the pool is a chain linked, at least 5 ft in length. The gate swings away from the pool, and the gate can close without assistance. There is a self self-latching device located no more than six inches from the top of the gate. The pool and fencing is approved and meets licensing regulations.

Licensee provided an updated facility sketch which reflected the plant modifications, photographs were taken of the pool area.


A copy of this report was provided to the licensee on this date 06.23.20.
SUPERVISOR'S NAME: Mariela RamonTELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Victoria HuntTELEPHONE: (661) 568-8930
LICENSING EVALUATOR SIGNATURE:

DATE: 06/23/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/23/2020
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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