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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364820077
Report Date: 09/15/2025
Date Signed: 09/15/2025 12:33:45 PM

Document Has Been Signed on 09/15/2025 12:33 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 DEL REY STATE PRESCHOOLFACILITY NUMBER:
364820077
ADMINISTRATOR/
DIRECTOR:		NANCY CRUZFACILITY TYPE:
850
ADDRESS:15332 DEL REY DRIVE, ROOM #23TELEPHONE:
(760) 245-7941
CITY:VICTORVILLESTATE: CAZIP CODE:
92395
CAPACITY: 24TOTAL ENROLLED CHILDREN: 24CENSUS: 18DATE:
09/15/2025
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:18 AM
MET WITH:Alma Valencia, Lead TeacherTIME VISIT/
INSPECTION COMPLETED:
12:40 PM
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On 9/15/25, Licensing Program Analyst (LPA) Crystal Ali met with Licensee, for the purpose of an unannounced Annual/Random inspection. LPA disclosed the purpose of the inspection and was granted entry to the facility. Upon arrival, teacher/child ratios were observed in compliance. LPA observed 18 children and 2 teachers, present during this inspection. The facility hours of operation are from 7:45am-10:45am and 11:30am-2:30pm, Monday-Friday. Incidental Medical Services (IMS) were discussed. Facility representative states that there are two children with medical needs. Facility representative states there is no weapons or smoking the premises.
Staffing Ration and Capacity: Upon arrival, LPA observed 1 classroom in use with a total of 18 children in state preschool classroom. Care and supervision were evaluated to determine if the children’s basic needs were met and appropriate. Sign-in and out sheets were observed on tablets at entrance of classroom. LPA observed parents sign out their child during inspection.
Physical Plant: LPA toured and inspected the infant classroom. Furniture, equipment, and toys were checked for age appropriateness and good repair. The classroom is clean and safe. Telephone service was verified. Heating, lighting, and ventilation are adequate. There are cubbies for children’s belongings labeled with their names. Daily activities schedule was observed on the parent board next to classroom door.
Claretta Yates
Crystal Ali
DATE: 09/15/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/15/2025
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 DEL REY STATE PRESCHOOL
FACILITY NUMBER: 364820077
VISIT DATE: 09/15/2025
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Drinking water is available inside the classrooms in the form of disposable cups next to classroom door. Parents provide pull ups and wipes for those children potty training. All containers used for storage of solid wastes, including moveable bins, shall have a tightfitting cover that is kept on; they shall be leakproof and rodent-proof. LPA observed trash cans in classroom all have lids including a diaper genie in staff office area. LPA informed teacher that the school must provide a changing area for the children that include a changing table or a changing pad. LPA observed a water table, sand table, large TV, portable sink, clam area, staff office (has microwave, and refrigerator, and two large cabinets, and one filing cabinet), and children allergies posted on wall next to front window, several tables and chairs.

Napping: Per facility representative, due to the class schedule the facility does not provide napping. However, there is a rest area for children towards the back of the classroom.

Bathroom: LPA observed the girl’s bathroom that is used for the preschool children. Staff escorts the children to the bathroom when daily while insuring to be on ratio. The bathroom has one 5 toilets and 3 sinks. The children also utilize another restroom closer to the playground when they are outside.

Medication: Children are inspected for illnesses as they arrive with a no-touch thermometer and an overall wellness check. A review of medication policy indicated that prescription medication is administered only with the parent’s written permission. The teacher will administer medication and document the dosage, date, and time on a log. Medication is brought and safety latched at the center (unless the parent requests daily return). Medication is labeled correctly and stored in its original container. Medication is kept at the blue large cabinet inaccessible to children next to teacher desk. Teacher do not dispose of medication, all medication when completed is returned to the parent for disposal. There are currently two children in care with IMS needs.

SUPERVISOR'S NAME: Claretta Yates
LICENSING EVALUATOR NAME: Crystal Ali
LICENSING EVALUATOR SIGNATURE:

DATE: 09/15/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/15/2025
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 DEL REY STATE PRESCHOOL
FACILITY NUMBER: 364820077
VISIT DATE: 09/15/2025
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Children are isolated when ill by placing them in rest area away from other children until parents arrive to pick them up. If the child need further assistant then child will be escorted to nurses office until parents arrive for pick up.

Lead Water Testing: Lead water testing as completed and approved on 11/7/22. LPA observed these results during annual inspection.


The Outdoor: The play equipment was inspected for health, safety, cushioning material, good repair, and age appropriateness. The outdoor play equipment was inspected for health, safety, cushioning material, good repair, and age appropriateness. There are no bodies of water on the premises. The facility has a separate fenced playground yard for school-age and preschool children. LPA observed a large play equipment with two slides, large tricycle track, and two tunnels. The play area has a shed that house all of the preschool toys. There is a large, shaded area in front of the classrooms that exit into the playground. There is a side yard right next to classroom that facility representative states they use occasionally and have popsicles there. The area has three small tables for children and a plant box.
Fire Extinguisher: Fire/earthquake drills are current and completed every 6 months. Last disaster drill completed on 8/28/25 at 9:00am. A fire extinguisher is in the green (service last checked 9/2025), inaccessible to children mounted on the wall near front entrance of facility. Smoke detector, and a carbon monoxide detector are on the premises and in compliance with fire marshal standards. Lead teacher is unsure of when fire marshall came last to the school since the administration handles that task. LPA observed a first aid kit located in the blue cabinet that has safety latch on it, inaccessible to children. There is also an emergency backpack located at the entrance of the classroom.
SUPERVISOR'S NAME: Claretta Yates
LICENSING EVALUATOR NAME: Crystal Ali
LICENSING EVALUATOR SIGNATURE:

DATE: 09/15/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/15/2025
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 DEL REY STATE PRESCHOOL
FACILITY NUMBER: 364820077
VISIT DATE: 09/15/2025
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Transportation: The facility does not provide transportation for children.
Staff/ Children Records: LPA reviewed with licensee the LIC 125, records to be maintained at the facility, for child’s records, personnel records, administrative records, and parent board. Staff and child records were reviewed. LPA reviewed 3 children's records and 2 staff records. Staff and child files are in compliance. LPA observed LIC 500 on parent board and LIC 9040 on school online system.
Kitchen/Food Service: There is a fully equipped cafeteria and kitchen (off limits). The facility provides breakfast, snack, and lunch. Lunch is obtained from school’s cafeteria. LPA observed menu on parent board. Morning class get breakfast and afternoon class gets lunch. Teachers go to kitchen to pick up the food for the children.

To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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/inspection-process.

Criminal Record Clearance - Child Care Centers
Licensee 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.
SUPERVISOR'S NAME: Claretta Yates
LICENSING EVALUATOR NAME: Crystal Ali
LICENSING EVALUATOR SIGNATURE:

DATE: 09/15/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/15/2025
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 DEL REY STATE PRESCHOOL
FACILITY NUMBER: 364820077
VISIT DATE: 09/15/2025
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Lead Testing – Child Care Centers (CCC)
CCC COMPLETED TESTING AND NO LEAD EXCEEDANCES:
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.
Safe Sleep - Child Care Centers
LPA discussed the safe sleep regulations with facility representative and
discussed the Child Care Licensing Safe Sleep webpage at
https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep as an additional resource. LPA also informed facility
of the importance of checking for recalled infant devices on the United States
Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and
recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.
Incidental Medical Services (IMS) - Child Care Centers
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/. PIN 22-05-CCP
SUPERVISOR'S NAME: Claretta Yates
LICENSING EVALUATOR NAME: Crystal Ali
LICENSING EVALUATOR SIGNATURE:

DATE: 09/15/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/15/2025
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 DEL REY STATE PRESCHOOL
FACILITY NUMBER: 364820077
VISIT DATE: 09/15/2025
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MyChildCarePlan.org – Child Care Centers
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.
Subscribe to CCLD important information - Child Care Centers
Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platforms. To receive important licensed related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-carelicensing/
subscribe and select the Child Care option to receive email communication.

No deficiencies cited in accordance with Title 22 of the California Code of Regulations and Health & Safety codes.

Exit interview conducted and report was reviewed with the Lead Teacher, Alma Valencia.

SUPERVISOR'S NAME: Claretta Yates
LICENSING EVALUATOR NAME: Crystal Ali
LICENSING EVALUATOR SIGNATURE:

DATE: 09/15/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/15/2025
LIC809 (FAS) - (06/04)
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