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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 367700045
Report Date: 05/03/2022
Date Signed: 05/03/2022 01:31:33 PM


Document Has Been Signed on 05/03/2022 01:31 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: 9DATE:
05/03/2022
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
10:38 AM
MET WITH:Licensee Cassandra Haney TIME COMPLETED:
11:05 AM
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On May 3, 2022 at 10:38am, Licensing Program Analyst (LPA) Kendal Zirbes conducted an unannounced Plan of Correction (POC) inspection. The purpose POC inspection was to clear deficiencies cited on April 26, 2022. Present during today’s inspection were nine children and two staff members (Licensee and Staff 1).

A tour of the facility was conducted at 10:45am. Based on LPAs observations on this day the facility was within the ratio and capacity. No deficiencies were observed.

An exit interview was conducted, a copy of this report, and notice of site visit were provided to Licensee Cassandra Haney.
SUPERVISOR'S NAME: Carissa BellTELEPHONE: (661) 202-3359
LICENSING EVALUATOR NAME: Kendal ZirbesTELEPHONE: (661) 202-3491
LICENSING EVALUATOR SIGNATURE:
DATE: 05/03/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/03/2022
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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