<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191231164
Report Date: 07/16/2021
Date Signed: 07/28/2021 12:09:04 PM

Document Has Been Signed on 07/28/2021 12:09 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:PRINGLE FAMILY DAY CAREFACILITY NUMBER:
191231164
ADMINISTRATOR:PRINGLE, ANNIEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(818) 361-5014
CITY:SYLMARSTATE: CAZIP CODE:
91342
CAPACITY: 12TOTAL ENROLLED CHILDREN: 0CENSUS: 2DATE:
07/16/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:50 PM
MET WITH:Annie PringleTIME COMPLETED:
02:45 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Licensing Program Analyst (LPA) Justin Dorsey conducted an unannounced annual random inspection at Pringle Family Day Care. LPA met with licensee Annie Pringle. During today's inspection LPA observed 2 children present. Per licensee the 2 children are family members who reside in the home.

During today's inspection LPA toured the facility, checked associations and reviewed the licensees records. Due to the licensee having a doctors appointment at 3:00pm the inspection was not completed. LPA will return to the facility at a later date to complete the inspection.

Licensee signed this report 07/28/21.

SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Justin Dorsey
LICENSING EVALUATOR SIGNATURE: DATE: 07/16/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/16/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 1