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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197700450
Report Date: 10/03/2023
Date Signed: 10/03/2023 01:06:44 PM

Document Has Been Signed on 10/03/2023 01:06 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:FERNANDEZ FAMILY CHILD CAREFACILITY NUMBER:
197700450
ADMINISTRATOR:BLANCA FERNANDEZFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(661) 964-7262
CITY:LANCASTERSTATE: CAZIP CODE:
93536
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 7DATE:
10/03/2023
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
12:59 PM
MET WITH:Blanca FernandezTIME COMPLETED:
01:15 PM
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On 10/3/2023, Licensing Program Analyst (LPA) Carol Heath conducted a Follow-up POC Inspection with Licensee Blanca Fernandez, who guided the analyst on a tour of the facility regarding the areas of concern. During today's inspection, there are 3 toddlers and 4 preschool age children with licensee.

LPA observed the following the self-latch on the pool gate is still need adjustment. The licensee will not allow the children to go outside until the pool gate is fix.


Exit interview conducted and report was reviewed with the Licensee, Blanca Fernandez
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Carol Heath
LICENSING EVALUATOR SIGNATURE: DATE: 10/03/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/03/2023
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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