<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197700354
Report Date: 03/05/2024
Date Signed: 04/26/2024 02:23:18 PM

Document Has Been Signed on 04/26/2024 02:23 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:WINGERT FAMILY CHILD CAREFACILITY NUMBER:
197700354
ADMINISTRATOR:WINGERT, SUSANNFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(818) 274-8355
CITY:PALMDALESTATE: CAZIP CODE:
93551
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 7DATE:
03/05/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
01:18 PM
MET WITH:TIME COMPLETED:
03:30 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
On April 26, 2024, at 2:20, the facility evaluation report dated 3/5/2024, was amended for the purpose to modify the report.

On March 5, 2024 1:15 pm Licensing Program Analysts (LPAs) Annelise Villa and Evelyn Garcia conducted an unannounced case management visit to follow up on an Unusual Incident Report concerning an incident that occurred on February 2, 2024. The unusual incident report was regarding an incident that occurred potentially at the day-care facility. Upon arrival today, there were 7 day care children in care, present during the inspection. Licensee and and two staff were present and providing supervision at the time of the inspection.

During this inspection, LPA conducted interviews with Licensee, staff members, children, and reviewed records. Based on the information gathered during interviews conducted, and record review, it was determined the incident did not appear to be a violations of Title 22 Regulations.

The licensee is encouraged to continue to report unusual incidents that occurred at the facility.

An exit interview was conducted and a copy of this report was provided to Licensee along with appeal rights. A notice of site visit was given and must remain posted for 30 days.
SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Annelise Villa
LICENSING EVALUATOR SIGNATURE: DATE: 03/05/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/05/2024
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 1