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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 367700305
Report Date: 03/05/2024
Date Signed: 03/05/2024 04:01:54 PM

Document Has Been Signed on 03/05/2024 04:01 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:LOBOS FAMILY CHILD CAREFACILITY NUMBER:
367700305
ADMINISTRATOR:MARTHA LOBOSFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(760) 974-7577
CITY:YUCCA VALLEYSTATE: CAZIP CODE:
92284
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 6DATE:
03/05/2024
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
03:10 PM
MET WITH:Licensee Martha Lobos TIME COMPLETED:
04:10 PM
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On March 5, 202, at 03:10 p.m., Licensing Program Analyst (LPA) Kendal Zirbes conducted an unannounced Plan of Correction (POC) inspection and met with Licensee Martha Lobos. LPA disclosed the purpose of the inspection and was granted entry into the facility by the Licensee. A total of six children were present (one infant, four preschool age and one school age child) with the Licensee providing supervision.
During this inspection, LPA completed a tour of the facility at 03:20 p.m., and observed the following:
1. The play yard was free of all loose items.
2. Documentation of the 15 minute safe sleep checks were being recorded.
3. Per conversation with the Licensee, the Licensee reviewed the safe sleep videos. During this inspection, LPA received a written statement from the Licensee declaring the Safe Sleep video was reviewed.
4. LPA reviewed the child files and observed immunization records were obtained.

Based on LPA record review the citations issued on 2.22.24 were corrected.

A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the Licensee Martha Lobos.
SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Kendal Zirbes
LICENSING EVALUATOR SIGNATURE: DATE: 03/05/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/05/2024
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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