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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 192004328
Report Date: 10/30/2024
Date Signed: 10/30/2024 02:05:59 PM

Document Has Been Signed on 10/30/2024 02:05 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:CAMILO FAMILY CHILD CAREFACILITY NUMBER:
192004328
ADMINISTRATOR/
DIRECTOR:		CAMILO, ELIZABETHFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(661) 236-2760
CITY:PALMDALESTATE: CAZIP CODE:
93550
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 5DATE:
10/30/2024
TYPE OF VISIT:POCUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:54 PM
MET WITH: Elizabeth Camilo, Licensee TIME VISIT/
INSPECTION COMPLETED:
02:15 PM
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On 10/30/24, Licensing Program Analyst (LPA) Justeene Tamayo conducted a Case Management- Plan of Correction (POC) in person inspection at the above facility to verify there are no uncleared adults at the facility. Upon arrival LPA was greeted by licensee, Elizabeth Camilo.

During today's inspection LPA observed 2 school age children, and 3 preschool children in care with the licensee, along with assistant #1 (fingerprint cleared). LPA did not observe uncleared adults at the facility today. Plan of Correction for the Type A deficiency cited on 10/15/24 has been cleared. Plan of Correction letter was provided to the licensee.

The licensee was informed the presence of any adults in the home without Criminal Record Clearance or Exemption and not associated to facility will be cited and civil penalty assessed for $100 per day.

No deficiencies have been cited at this time.

An exit interview was conducted, a copy of this Report, Appeal Rights, and Notice of Site Visit were provided to licensee Elizabeth Camilo.

SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Justeene Tamayo
LICENSING EVALUATOR SIGNATURE: DATE: 10/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/22/2024
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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