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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197418025
Report Date: 03/22/2024
Date Signed: 03/22/2024 11:02:53 AM

Document Has Been Signed on 03/22/2024 11:02 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:HANNA FAMILY CHILD CAREFACILITY NUMBER:
197418025
ADMINISTRATOR:HANNA, MARIANNEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(310) 622-2515
CITY:CANYON COUNTRYSTATE: CAZIP CODE:
91387
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 7DATE:
03/22/2024
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
09:35 AM
MET WITH:Marianne Hanna, LicenseeTIME COMPLETED:
11:10 AM
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On Friday, March 22, 2024 Licensing Program Analyst (LPA) Mayra Rivera conducted an unannounced case management inspection and met with licensee Marianne Hanna. The purpose of this visit was to review the 6 Type B deficiencies that were given on February 16, 2024. LPA observed 2 infants and 5 preschool children present with assistant and licensee. LPA reviewed the drill log dated 2/28/24, reviewed 15 minutes sleep logs, staff and licensee immunization's, infants LIC 9227 Individual Infant Sleeping Plan and children files complete with required documentation such as LIC 700 Identification and Emergency Information Child Care, LIC 627 Consent for Emergency Medical Treatment, LIC 995 Acknowledgement of Notification of Parent's Rights, LIC 9150 Additional Children in Care, LIC 282 Affidavit Regarding Liability Insurance, and completed Blue Immunization card.

LPA also provided the LIC 311D-Forms Records to Keep in Family Child Care Home. LPA Rivera cleared the 6 deficiencies during this visit. LPA also provided the Letters of Deficiency Citations Cleared.

A notice of site visit was given and must remain posted for 30 days.

An exit interview was conducted, during which this report and the Appeal Rights were discussed with licensee Marianne Hanna.


SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Mayra Rivera
LICENSING EVALUATOR SIGNATURE: DATE: 03/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/22/2024
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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