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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197408240
Report Date: 04/14/2023
Date Signed: 04/14/2023 10:03:05 AM

Document Has Been Signed on 04/14/2023 10:03 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
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME:PALMDALE SCH. DIST.-TIERRA BONITA (NO.) HEAD STARTFACILITY NUMBER:
197408240
ADMINISTRATOR:DR. MELANIE CULVERFACILITY TYPE:
850
ADDRESS:44900 27TH STREET EASTTELEPHONE:
(661) 946-4126
CITY:LANCASTERSTATE: CAZIP CODE:
93535
CAPACITY: 24TOTAL ENROLLED CHILDREN: 24CENSUS: 10DATE:
04/14/2023
TYPE OF VISIT:Case Management - Annual ContinuationUNANNOUNCEDTIME BEGAN:
08:52 AM
MET WITH: Lead Teacher, Arasely WencesTIME COMPLETED:
10:18 AM
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Licensing Program Analyst (LPA) Maddox met with Lead Teacher, Arasely Wences, and Assistant Administrator, Lisa Fowler today for the purpose of concluding the Annual inspection which began on 4/13/2023. This inspection is conducted to review children and staff records.

With regards to Lead testing, staff state food is prepared at Tamarisk Elementary School and delivered to this site daily. This location has a Sparklets water cooler for drinking water, water is brought out in pitchers with disposable cups. Staff state the Tamarisk Elementary School did the lead testing in December 2022.

Exit interview conducted, a copy of this report was left at this site. No citations were issued as a result of this Annual Continuation inspection.
SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Donna Maddox
LICENSING EVALUATOR SIGNATURE: DATE: 04/14/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/14/2023
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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