<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 367750049
Report Date: 11/17/2023
Date Signed: 11/17/2023 04:55:34 PM

Document Has Been Signed on 11/17/2023 04:55 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:OAK TREE D STREETFACILITY NUMBER:
367750049
ADMINISTRATOR:MELISSA DAVISFACILITY TYPE:
850
ADDRESS:1900 D STREETTELEPHONE:
(909) 882-6979
CITY:SAN BERNARDINOSTATE: CAZIP CODE:
92405
CAPACITY: 50TOTAL ENROLLED CHILDREN: 50CENSUS: 12DATE:
11/17/2023
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Facility Representative Juanita Gutierrez and Administrator Melissa Davis. TIME COMPLETED:
10:00 AM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
On November 17, 2023, at 9:30 a.m. Licensing Program Analyst (LPA) Kendal Zirbes met with Facility Representative Juanita Gutierrez. The purpose of the inspection was to conduct a unannounced POC inspection at the licensed facility. LPA disclosed the purpose of the inspection to the facility representative. Present during today’s inspection were 12 preschool age children, one teacher (staff 1 (S1)), and one aide (staff 2 (S2).

Based on LPA observation the facility is meeting the required ratios at the time of this inspection.
Prior to this inspection, LPA received a copy of the staff training which was completed on November 8, 2023.

Based on LPAs record review and observations, the citations issued on November 03, 2023 have been corrected.

A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the Administrator Melissa Davis.
SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Kendal Zirbes
LICENSING EVALUATOR SIGNATURE: DATE: 11/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/17/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 1