364811636-9-30-2025-12-CC-KZIS-DLZQRY-20250930122442

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 364811636
Report Date: 09/30/2025
Date Signed: 09/30/2025 12:25:01 PM

Document Has Been Signed on 09/30/2025 12:25 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 CC RO, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME:	SBCSS YUCCA VALLEY STATE PRESCHOOL		FACILITY NUMBER:	364811636
ADMINISTRATOR/ DIRECTOR:	NANCY ALVARADO		FACILITY TYPE:	850
ADDRESS:	7601 HOPI TRAIL, ROOM K-3		TELEPHONE:	(760) 365-3381
CITY:	YUCCA VALLEY	STATE: CA	ZIP CODE:	92284
CAPACITY: 24	TOTAL ENROLLED CHILDREN: 17	CENSUS: 6	DATE:	09/30/2025
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	10:05 AM
MET WITH:	Facility Representative Susan Yakutis		TIME VISIT/ INSPECTION COMPLETED:	12:40 PM

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 September 30, 2025, at 10:05am, Licensing Program Analyst (LPA) Kendal Zirbes conducted an unannounced Annual/Random Inspection and met with Facility Representative Susan Yakutis. LPA disclosed the purpose of the inspection and was granted entry into the facility by the Facility Representative. Six preschool age children, one teacher and one aide were present at the facility during the inspection. The preschool program operates out of one classroom, two restrooms, and an outdoor play space. The classroom is located on the campus of Yucca Valley Elementary school. The programs hours of operation are Monday thru Friday 7:15 am -3:15. The preschool program has two sessions each day, AM session 8:00 AM -11:00AM and PM session 11:45am- -2:45 P.M. The center has an approved waiver on file regarding the restrooms. Indoor/Children's Area: Child care center was observed to be clean, safe, sanitary and in good repair; all outdoor and indoor passageways, stair ways, incline, ramps, open porches and other areas of potential hazard are kept free of obstruction; floors of all rooms have a surface that is safe and clean. Cleaning compounds were stored in a key locked cabinet and were therefore inaccessible. No poisons were stored on the premises, furniture/equipment is in good condition. Classroom was free of flies, other insects, rodents. The classroom had tables and chairs to meet children’s needs. LPA observed the classroom had a dramatic play area, science area, library and additional areas for instruction. The classroom had diverse play equipment, along with multiple blocks, puzzles and age appropriate materials. Children's belongings are kept in cubbies along the wall as you enter classroom. Trash cans for solid waste have tight fitting lids, drinking water is readily available indoors via an igloo cooler and cups. All materials and surfaces are toxic free, window screens in good repair and free of debris. LPA observed a carbon monoxide detector and smoke detectors and fire extinguisher in the classroom. Report continued on page two

NAME OF LICENSING PROGRAM MANAGER: Lady King
NAME OF LICENSING PROGRAM ANALYST: Kendal Zirbes
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 09/30/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/30/2025

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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California Health & Human Services Agency

California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:

Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.

Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)

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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
PALMDALE CC RO, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: SBCSS YUCCA VALLEY STATE PRESCHOOL	FACILITY NUMBER: 364811636
	VISIT DATE: 09/30/2025

NARRATIVE

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Report continued from page one
There was working telephone service on the premises. There is an isolation area for children who become ill. The isolation area is located in the classroom. The facility maintains a comfortable temperature at all times. Facility staff complete daily symptoms screening. Smoking is prohibited on the premises. LPA did not observe prohibited childcare items during this inspection. Firearms/weapons are not allowed or stored on premises per facility representative. LPA did not observe bodies of water on the premises, facility representative confirmed there are zero bodies of water on the property. Breakfast is provided to the AM session and lunch is provided to the PM session. The meals are provided by the school cafeteria.
Napping
The preschool program offers half day programs, therefore, the children do not nap at the facility. The classroom does have designated areas for relaxation and quite play.
Outdoor
LPA inspected the outdoor play space for health, safety, cushioning material, good repair and age appropriateness. The area has a trikes, dramatic play equipment, balls and additional age appropriate outdoor materials. LPA observed a wooden table in the outdoor activity space. When LPA ran their hand along the table top the wood was rough to the touch. LPA advised the Center to have the table treated and the rough areas sanded down. LPA observed approximately 15 empty chip bags/candy wrappers, and a rake in the outdoor activity space near the perimeter fence behind the storage container. LPA did not observe the children playing within 50 feet of the debris. A barrier was not present which prevented the children from having access to the debris. When asked about the debris, facility representative stated the area is regularly cleaned and the debris is present due to the recent storm that effected the entire school campus. LPA advised the facility representative to ensure the outdoor activity space is free of debris when operating, an advisory notice was issued.
Child File and Staff File Review:
LPA reviewed three staff files. Per LPA review the staff files were complete and contained all required information. During the inspection, LPA was unable to review the children's electronic files. Per information obtained from staff, a recent storm affected the schools internet, therefore the staff were unable to access the files. Children's emergency cards were available and reviewed. An advisory notice was issued due to child files being unavailable during this inspection.

Report continued on page three

NAME OF LICENSING PROGRAM MANAGER: Lady King
NAME OF LICENSING PROGRAM ANALYST: Kendal Zirbes
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 09/30/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/30/2025

LIC809 (FAS) - (06/04)

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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
PALMDALE CC RO, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: SBCSS YUCCA VALLEY STATE PRESCHOOL	FACILITY NUMBER: 364811636
	VISIT DATE: 09/30/2025

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Report continued from page two
Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. When any IMS is provided, an updated Plan of Operation that includes IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-care-centers/.
Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test.
For child care center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1-CCP). LPA verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP.
Facility representative was reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated..
Facility representative was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.
To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.
Based on LPA record review, two technical advisory notices were issued. Furthermore, LPA verbally reminded facility representative to submit an unusual incident report in the future if the campus is effected by an natural disaster.
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, Susan Yakutis.

NAME OF LICENSING PROGRAM MANAGER: Lady King
NAME OF LICENSING PROGRAM ANALYST: Kendal Zirbes
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 09/30/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/30/2025

LIC809 (FAS) - (06/04)

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