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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 367750049
Report Date: 06/25/2024
Date Signed: 06/25/2024 10:27:46 AM

Document Has Been Signed on 06/25/2024 10:27 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 CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME:OAK TREE D STREETFACILITY NUMBER:
367750049
ADMINISTRATOR/
DIRECTOR:		MELISSA DAVISFACILITY TYPE:
850
ADDRESS:1900 D STREETTELEPHONE:
(909) 882-6979
CITY:SAN BERNARDINOSTATE: CAZIP CODE:
92405
CAPACITY: 50TOTAL ENROLLED CHILDREN: 50CENSUS: 21DATE:
06/25/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:14 AM
MET WITH:Facility Representative Ghada Ponce and Juanita Gutierrez.TIME VISIT/
INSPECTION COMPLETED:
10:40 AM
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On June 25, 2024, at 09:11 a.m. Licensing Program Analyst (LPA) Kendal Zirbes met with facility representative Ghada Ponce. The purpose of the inspection was to conduct a unannounced case management inspection at the licensed facility. LPA disclosed the purpose of the inspection to the facility representative. Present during today’s inspection were 15 preschool children, six toddlers, three teachers, one aide and two administrative staff members.

LPA discussed the following with facility representative:
1. Waiver request regarding shared Outdoor Activity Space for preschool children and Key Essentials school located on the First Presbyterian Church.
2. Updated facility sketch and letter to the Department regarding the boys bathroom no longer being utilized by the preschool program.

A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the facility representative Juanita Gutierrez.


SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Kendal Zirbes
LICENSING EVALUATOR SIGNATURE: DATE: 06/25/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/25/2024
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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