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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 153800355
Report Date: 08/19/2022
Date Signed: 08/22/2022 05:47:23 AM

Document Has Been Signed on 08/22/2022 05:47 AM - 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:LITTLE TIKES FAMILY DAY CAREFACILITY NUMBER:
153800355
ADMINISTRATOR:CROWELL, MARISOLFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(760) 373-3198
CITY:CALIFORNIA CITYSTATE: CAZIP CODE:
93505
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 1DATE:
08/19/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Dwane CrowellTIME COMPLETED:
12:55 PM
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 On 08/19/22 at 11:30 a.m. Licensing Program Analyst (LPA) Esequiel Rodriguez while conducting an unannounced inspection visit at the Facility. Upon arrival, the LPA met with the Licensee's son (Dwane Crowell) He stated that his mom, (Licensee) passed away recently. He stated that he did notified the Department about it.
Mr. Crowell is associated to the Facility and assisted his mom in caring for children, Currently, he is in the process of submitting a new application for licensure.

LPA provided technical assistance regarding proper submission of new application for licensure.

An exist interview was conducted and a copy of this report was provided to Mr. Crowell.
SUPERVISORS NAME: Scott Herring
LICENSING EVALUATOR NAME: Esequiel Rodriguez
LICENSING EVALUATOR SIGNATURE: DATE: 08/19/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/19/2022
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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