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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197412230
Report Date: 05/13/2022
Date Signed: 05/13/2022 11:27:54 AM

Document Has Been Signed on 05/13/2022 11:27 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:MAYER FAMILY CHILD CAREFACILITY NUMBER:
197412230
ADMINISTRATOR:MAYER, MICHELLEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(661) 285-5077
CITY:PALMDALESTATE: CAZIP CODE:
93552
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 6DATE:
05/13/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
11:06 AM
MET WITH:Michelle MayerTIME COMPLETED:
11:42 AM
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Licensing Program Analyst (LPA) Justin Dorsey, met with Licensee Michelle Mayer for a Case Management - Other inspection.

On 05/13/22 LPA Dorsey advised Director Michelle Mayer that no banned or recalled equipment should be kept in the home. Technical Assistance was given today 05/13/22.

During the inspection the following was observed:
  • LPA Dorsey observed a baby bouncer in the homes main care area. LPA observed the baby bouncer was removed from the main care area to the garage. Per licensee the baby bouncer will be sent home with the child.


An exit interview was conducted, a copy of this report was read and provided to Licensee, Michelle Mayer.
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Justin Dorsey
LICENSING EVALUATOR SIGNATURE: DATE: 05/13/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/13/2022
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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