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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 367700045
Report Date: 04/11/2022
Date Signed: 04/11/2022 05:35:38 PM


Document Has Been Signed on 04/11/2022 05:35 PM - It Cannot Be Edited

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:HANEY FAMILY CHILD CAREFACILITY NUMBER:
367700045
ADMINISTRATOR:HANEY, CASSANDRAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(760) 910-3573
CITY:TWENTYNINE PALMSSTATE: CAZIP CODE:
92277
CAPACITY:14CENSUS: 2DATE:
04/11/2022
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
03:27 PM
MET WITH:Cassandra Haney LicenseeTIME COMPLETED:
05:45 PM
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License Program Analyst (LPA) Steven Montoya visited the Haney Family child care home conducted incident inspection concerning the Unusual Incident report dated 4-11-2022. At the time of the inspection, licensee had (2) toddlers in care, along with two her adolescent female children.

The purpose of the inspection is to follow up on by reports of sexual molestation by licensee family child on another family members child. Licensee reports hours of operation: Monday through Friday 6am to 5 pm.

LPA tour the entire home including off limit areas, interviewed licensee and relevant witnesses. Licensee provided an updated Child Care Facility Roster.

Based on the information obtain, further investigation is required. A copy of the report, appeal rights and notice of site visit was provided to the licensee.

Exit

SUPERVISOR'S NAME: Claretta YatesTELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Steven MontoyaTELEPHONE: (661) 202-4701
LICENSING EVALUATOR SIGNATURE:
DATE: 04/11/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/11/2022
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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