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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197700633
Report Date: 11/06/2023
Date Signed: 11/06/2023 12:00:37 PM

Document Has Been Signed on 11/06/2023 12:00 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:MOLINA FAMILY CHILD CAREFACILITY NUMBER:
197700633
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: DATE:
11/06/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
10:20 AM
MET WITH:Susana MolinaTIME COMPLETED:
11:55 AM
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On 11/06,2023 at 10:20 A.M. Licensing Program Analyst (LPA) Joselito L. Del Mundo conducted an announced in-person inspection of the Molina Family Child Care Home. LPA met with applicant Susana Molina. The purpose of the inspection is to conduct a follow-up Capacity Increase Inspection to review the corrections required for licensure. LPA and Applicant toured the facility inside and out to ensure the home meets State Licensing Title 22 Regulations. During this inspection, there was one child being supervised by the applicant and assistant.

During the last inspection on 10/04/2023, LPA observed what appears to be dead/dried tree branches with sharp edges in the outdoor play area. During today’s inspection, applicant stated that she consulted with a plant expert. According to applicant, plant expert stated that the tree branches with sharp edges that were still attached on the tree are not decease and they may look like dead tree branches because of the changing season. Applicant was advised to supervise children when playing outside and to keep an eye on the tree branches.

LPA also observed that the metal fence enclosing one side of the outdoor play area was replaced with a concrete wall.



There were no deficiencies cited today. As a result of this inspection, the home does meet Title 22 Regulations for a large family child care license. The applicant is ready for licensure pending the manager's approval.

An exit interview was conducted, Notice of Site Visit, and Appeal Rights were provided with the applicant Susana Molina.

SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Joselito DelMundo
LICENSING EVALUATOR SIGNATURE: DATE: 11/06/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/06/2023
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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