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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197700076
Report Date: 10/15/2024
Date Signed: 10/15/2024 12:57:02 PM

Document Has Been Signed on 10/15/2024 12:57 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
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME:SERRANO FAMILY CHILD CAREFACILITY NUMBER:
197700076
ADMINISTRATOR/
DIRECTOR:		SERRANO, TOMASAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(818) 809-6722
CITY:NEWHALLSTATE: CAZIP CODE:
91321
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 10DATE:
10/15/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:31 PM
MET WITH:Tomasa Serrano, LicenseeTIME VISIT/
INSPECTION COMPLETED:
01:44 PM
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On October 15, 2024, Licensing Program Analyst (LPA) Isabel Ortega met with Licensee Tomasa Serrano to conduct an unannounced case management inspection. The purpose of this case management is to follow up on a self reported unusual incident report (UIR) submitted to the Department on 10/15/2024. The unusual incident report is regarding the back yard and main home Physical Plant with an underground pool.

Upon arrival, there were 10 children observed in care and 2 staff proving care and supervision.

During this inspection LPA was provided with the facility roster. LPA toured the outdoor back yard conduction. In addition, LPA completed a safety inspection of the facility.

According to interviews conducted with staff back yard is off limits. LPA observed the doors leading to the back and pool to be key locked. According to Licensee supervision is always maintained. The childcare area is separate from the main home. Parents were notified. According to the licensee the estimated last day of constructed is scheduled to be 10/18/2024.

An exit interview was conducted, a copy of this report, notice of site visit and appeal rights were provided to facility. A notice of site visit was provided and requested to be posted for 30 days.

SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Isabel Ortega
LICENSING EVALUATOR SIGNATURE: DATE: 10/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/15/2024
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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