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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 367700269
Report Date: 03/15/2023
Date Signed: 03/15/2023 09:33:19 AM

Document Has Been Signed on 03/15/2023 09:33 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
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME:CERON FAMILY CHILD CAREFACILITY NUMBER:
367700269
ADMINISTRATOR:JULIA CERONFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(818) 339-5858
CITY:VICTORVILLESTATE: CAZIP CODE:
92392
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 4DATE:
03/15/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
09:14 AM
MET WITH:Julia CeronTIME COMPLETED:
09:32 AM
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On 3/15/2023, Licensing Program Analyst (LPA) Carol Heath and Barbara Beneroso conducted a Case Management- other. Upon arrival at the facility, LPAs observed 4 children with licensee and her assistant in care.

The purpose of the visit is to amend the Facility Evaluation Report on 02/22/2023.

On 02/22/2023, LPAs conducted a POC visit. On the facility evaluation report, a child’s name (5 years old) was shown in the report. Also, LPA Heath used an abbreviation (IZ) for children’s Immunization shot records.
Also LPAs confirmed 3/20/23 NCC meeting at 10:00 with Licensee Julia Ceron.

An exit interview was conducted. The report was read and reviewed with the licensee, Julia Ceron.
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Carol Heath
LICENSING EVALUATOR SIGNATURE: DATE: 03/15/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/15/2023
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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