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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197750165
Report Date: 05/16/2024
Date Signed: 05/17/2024 09:35:14 AM

Document Has Been Signed on 05/17/2024 09:35 AM - 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 CC RO, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME:NOTRE DAME CHILDREN'S ACADEMY OF CASTAICFACILITY NUMBER:
197750165
ADMINISTRATOR/
DIRECTOR:		EDNA HERNANDEZFACILITY TYPE:
850
ADDRESS:31814 CASTAIC ROADTELEPHONE:
(661) 255-0053
CITY:CASTAICSTATE: CAZIP CODE:
91384
CAPACITY: 47TOTAL ENROLLED CHILDREN: 47CENSUS: 0DATE:
05/16/2024
TYPE OF VISIT:PrelicensingANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:20 AM
MET WITH:Edna Hernandez TIME VISIT/
INSPECTION COMPLETED:
11:28 AM
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Licensing Program Analyst (LPA) Maddox met with applicant Edna Hernandez today for the purpose of conducting a 2nd prelicensing inspection. Also present during this inspection was Fire Inspector, Frank Modugno and together we re-measured the pre-school components of the center which consist of 3 classrooms (Rooms 2,3,&5, previously PS classrooms were Rooms 1,2,3,4).

Room #1 - 511
Room #2 - 396
Room #3 - 348

Total capacity for Preschool = 1,255

An exit interview was conducted and a copy of this report was provided to the Applicant, Edna Hernandez . Final license determination will be made upon review of the Licensing Program Manager.
SUPERVISORS NAME: Deborah Lowe
LICENSING EVALUATOR NAME: Donna Maddox
LICENSING EVALUATOR SIGNATURE: DATE: 05/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/16/2024
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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