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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197419514
Report Date: 01/10/2024
Date Signed: 01/10/2024 12:55:01 PM


COMPREHENSIVE INSPECTION

Document Has Been Signed on 01/10/2024 12:55 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:MARROQUIN FAMILY CHILD CAREFACILITY NUMBER:
197419514
ADMINISTRATOR:MARROQUIN, VILMAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(661) 942-0904
CITY:LANCASTERSTATE: CAZIP CODE:
93534
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 0DATE:
01/10/2024
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME BEGAN:
12:28 PM
MET WITH:TIME COMPLETED:
01:15 PM
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The Licensee no longer lives at the address. The house appears to be empty and you can see into the home, no blinds or belongings in the home. LPA spoke with the neighbor John that lives next door at 44714, to the right of the Licensee's property, and the neighbor informed me that the Licensee moved out of state over a month ago.
SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Andrea Pittman
LICENSING EVALUATOR SIGNATURE: DATE: 01/10/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/10/2024
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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