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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 367700391
Report Date: 02/03/2025
Date Signed: 02/03/2025 10:49:11 AM

Document Has Been Signed on 02/03/2025 10:49 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:REQUENA FAMILY CHILD CAREFACILITY NUMBER:
367700391
ADMINISTRATOR/
DIRECTOR:		BRENDA REQUENAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(760) 680-8490
CITY:OAK HILLSSTATE: CAZIP CODE:
92344
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 5DATE:
02/03/2025
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:22 AM
MET WITH:Breanda Requena- LicenseeTIME VISIT/
INSPECTION COMPLETED:
11:00 AM
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On Monday, February 3, 2025 Licensing Program Analysts (LPA) Braddock conducted an unannounced Case Management- Licensee Initiated inspection at the facility to approve an additional room. LPA disclosed the purpose of the inspection and was permitted entry by the Licensee-Breanda Requena-. The Licensee guided the LPA on a tour of the facility. At the time of the visit, there were 5 (five) children present with licensee and two assistants.

Prior to this inspection the room was not utilized for daycare purposes and was an off-limit bedroom. The licensee wants to add this room in accordance with the facility sketch and use it as a nap room.

During this inspection, we observed room which Is located through the entry way on the left. The room is currently not being used. The licensee wants to make this room a nap room for all children in care. The room currently has on crib and cots for sleeping. Children will not play in this room. Playing and all other activities will continue to take place preschool room and toddler room. Licensee is aware that when children are sleeping someone must always remain awake.

SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Sherell Braddock
LICENSING EVALUATOR SIGNATURE: DATE: 02/03/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/03/2025
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
PALMDALE CC RO, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: REQUENA FAMILY CHILD CARE
FACILITY NUMBER: 367700391
VISIT DATE: 02/03/2025
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As a result of the inspection, LPA has approved the additional room to be utilized as a nap room.

This inspection was conducted in person. LPA read the report with Licensee, Breanda Requena and provided a copy of the report, Appeal Rights, and a Notice of Site Visit was given and must be posted for 30 days. Exit interview conducted.

SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Sherell Braddock
LICENSING EVALUATOR SIGNATURE:

DATE: 02/03/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/03/2025
LIC809 (FAS) - (06/04)
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