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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197750170
Report Date: 04/03/2024
Date Signed: 04/03/2024 04:10:34 PM

Document Has Been Signed on 04/03/2024 04:10 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:CCRC 10TH STREET HEAD STARTFACILITY NUMBER:
197750170
ADMINISTRATOR:
ADMINISTRATOR/
DIRECTOR:		BEATRIZ ZAMORANO-PEDREGONFACILITY TYPE:
850
ADDRESS:44236 10TH ST WESTTELEPHONE:
(661) 494-7999
CITY:LANCASTERSTATE: CAZIP CODE:
93534
CAPACITY: 80TOTAL ENROLLED CHILDREN: 80CENSUS: 36DATE:
04/03/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
TIME VISIT/
INSPECTION BEGAN:
09:48 AM
MET WITH:Lead Teacher Lynette WhitehurstTIME COMPLETED:
TIME VISIT/
INSPECTION COMPLETED:
04:30 PM
NARRATIVE
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On 4/3/2024 at 9:48am, Licensing Program Analyst (LPA) Andrea Pittman conducted an unannounced case management visit at the facility and was met by facility staff who permitted entry to the facility. LPA was later met by the Lead Teacher Lynette Whitehurst who joined and took over the visit. LPA toured the facility according to the facility sketch. Upon arrival, LPA observed 36 children with 7 staff members providing care and supervision.

LPA conducted a visit to acquire pertinent documentation and conduct interviews with relevant parties. LPA Pittman provided technical assistance in personal rights, reporting requirements, and Incidental Medical Services (IMS).

All licensing reports are recommended to be kept for 3 years. The Notice of Site visit is to be posted and visible to parents for 30 days, not meeting this requirement can result in a penalty of $100/day if it is not met.

An exit interview was conducted, a copy of this Report, a Notice of Site visit, and Appeal Rights were provided and discussed with the Facility Representative Lynette Whitehurst.

SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Andrea Pittman
LICENSING EVALUATOR SIGNATURE: DATE: 04/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/03/2024
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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