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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197700701
Report Date: 04/05/2024
Date Signed: 06/20/2024 05:44:32 PM

Document Has Been Signed on 06/20/2024 05:44 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:AZIZYAN FAMILY CHILD CAREFACILITY NUMBER:
197700701
ADMINISTRATOR/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 8DATE:
04/05/2024
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:45 PM
MET WITH:Nelly AzizyanTIME VISIT/
INSPECTION COMPLETED:
06:00 PM
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On 06/20/24 4:41, Licensing Program Analyst (LPA) Evelyn Garcia conducted a Case Management Deficiency inspection to address a violation that was observed on 04/05/24 during an inspection. Upon arrival, LPA met with Nelly Azizyan and observed 8 children in care.

102416.5(b)(3) - Staffing Ratio and Capacity- On 04/05/24, LPA observed 7 preschool children and 1 infant in care with the licensee and her assistant providing care and supervision. No school age children were present. The licensee stated that she was confused regarding ratios and will ensure that she will ensure her license capacity and ratios are within regulations.

The facility was cited a Type A violation.

Licensee will provide a copy of the licensing report that documents the Type A citation, to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

An exit interview was conducted, and a copy of this report was provided along with the appeal rights.
SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Evelyn Garcia
LICENSING EVALUATOR SIGNATURE: DATE: 06/20/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/20/2024
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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