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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197700170
Report Date: 01/25/2023
Date Signed: 01/25/2023 04:52:46 PM

Document Has Been Signed on 01/25/2023 04:52 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:DONN FAMILY CHILD CAREFACILITY NUMBER:
197700170
ADMINISTRATOR:DONN, AMAKAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(661) 992-1401
CITY:LANCASTERSTATE: CAZIP CODE:
93536
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 0DATE:
01/25/2023
TYPE OF VISIT:OfficeANNOUNCEDTIME BEGAN:
03:58 PM
MET WITH:Amaka Donn, LicenseeTIME COMPLETED:
04:53 PM
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On Wednesday, January 25, 2023, an office meeting was held by Mariela Ramon, Licensing Program Manager (LPM), Justeene Tamayo, Licensing Program Analyst (LPA) and Amaka Donn, Licensee.

The purpose of the meeting was to discuss the department’s concerns regarding a substantiated finding of Lack of Supervision dated on 12/20/22.

The purpose of the meeting is to discuss the department’s concerns with the operation of your facility and more in particular with a recent violation issued on 12/20/22 for neglect/lack of supervision. During interviews conducted, it was revealed that Licensee had taken school age children to the park and visually supervised the children in her car parked near the play area where the children were playing.

Licensee agrees to ensure compliance with the Department's regulations and ensure that children are guarded and protected. LPM explained that when a child is accepted in care, the licensee is responsible for ensuring that the child's needs are met and the health of safety of that child is primary. LPM reminded licensee of the importance of reassessing the supervision when day care children are provided with outdoor activities.

SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Justeene Tamayo
LICENSING EVALUATOR SIGNATURE: DATE: 01/25/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/25/2023
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 2
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: DONN FAMILY CHILD CARE
FACILITY NUMBER: 197700170
VISIT DATE: 01/25/2023
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Licensee was also informed that the Licensing Department's goal is to maintain compliance and keep the lines of communication open with the licensee by means of consultation with LPA Justeene Tamayo or an On Duty Analyst assistance.

The meeting was concluded, and a copy of this report was provided to the licensee today 01/25/23.

SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Justeene Tamayo
LICENSING EVALUATOR SIGNATURE:

DATE: 01/25/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/25/2023
LIC809 (FAS) - (06/04)
Page: 2 of 2