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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197700621
Report Date: 11/22/2022
Date Signed: 11/22/2022 12:24:25 PM

Document Has Been Signed on 11/22/2022 12:24 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:VALENCIA FAMILY CHILD CAREFACILITY NUMBER:
197700621
ADMINISTRATOR:VIRGINIA VALENCIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(323) 573-0124
CITY:LANCASTERSTATE: CAZIP CODE:
93535
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: DATE:
11/22/2022
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:Virginia ValenciaTIME COMPLETED:
01:05 PM
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On 11/22/2022, Licensing Program Analyst (LPA) Beneroso conducted an announced Pre-Licensee follow up inspection of the Valencia Family Child Care Home. LPA met with applicant Virginia Valencia . The purpose of the inspection is to conduct a follow-up Pre-Licensing Inspection to review the corrections required for licensure. LPA and Licensee toured the facility inside and out to ensure the home meets State Licensing Title 22 Regulations

During the inspections, LPA observed stairs railing being fixed and in well repair. At this moment, applicant is compliant with all the requirements asked by LPA.

As a result of this inspection, the home does meet Title 22 Regulations.
Applicant is ready for licensure as of 11/22/22.


Applicant was given the pre-licensing application packet with licensing forms included.
Exit interview conducted: A copy of this report was discussed and left with Virginia Valencia
SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Barbara Beneroso
LICENSING EVALUATOR SIGNATURE: DATE: 11/22/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/22/2022
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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