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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 147700001
Report Date: 05/21/2025
Date Signed: 05/21/2025 02:18:31 PM

Document Has Been Signed on 05/21/2025 02:18 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:Ayala Family Child CareFACILITY NUMBER:
147700001
ADMINISTRATOR/
DIRECTOR:		Mirta AyalaFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(442) 228-4055
CITY:BishopSTATE: CAZIP CODE:
93514
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: DATE:
05/21/2025
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:00 PM
MET WITH:Mirta Ayala, LicenseeTIME VISIT/
INSPECTION COMPLETED:
02:20 PM
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On 5/21/24, Licensing Program Analysts (LPAs) Crystal Ali and Carol Heath conducted an unannounced annual random inspection. The LPAs disclosed the purpose of the inspection and was granted entry by the Licensee. The Licensee guided the LPAs on a tour of the home. Upon entry to the facility, the LPAs observe 7 children in care (includes three infants) and licensee and husband (assistant) providing care and supervision (fingerprint cleared and associated to the center). Licensee's facility child roster is current and maintained up to date. Licensee states no child with IMS needs. The operational childcare hours are Monday through Saturday from 4am to 5pm.
Staffing Ration and Capacity: This is a one-story family home. There is a living room (daycare area), dining room (daycare area), kitchen (daycare area), two bedrooms, one bathroom, and backyard. The off-limits areas are the two bedrooms, hallway closet, laundry closet, furnace door in hallway, and the front yard/porch. In the daycare area there are cubbies for the children belongings can be placed. LPAs reviewed parent board documentation and provided updated documents to the licensee to post. Licensee had all the required posted documents: Facility License (LIC 203A, Notice of Parent's Rights Poster (PUB 394), Emergency Disaster Plan (LIC 610A), and Earthquake Preparedness Checklist (LIC 9148).
NAME OF LICENSING PROGRAM MANAGER: Claretta Yates
NAME OF LICENSING PROGRAM ANALYST: Crystal Ali
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 05/21/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/21/2025
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: Ayala Family Child Care
FACILITY NUMBER: 147700001
VISIT DATE: 05/21/2025
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610A), and Earthquake Preparedness Checklist (LIC 9148).
Physical Plant: Daycare area is the living room, bathroom, dining room, kitchen and backyard. Licensee does provide drinks, morning snacks, and afternoon snacks. The children bring packed lunches. Lunchboxes are placed in the refrigerator for the children in care. Licensee is not in the food program. The home was inspected inside and out for safety, comfort, cleanliness, telephone service, heating and ventilation, inaccessibility to poisons, detergents, cleaning compounds, medicines, and hazardous items that can pose a danger to children. There are no window blind cords on the windows. Facility has no pets on premises. Facility has a landline and cell phone both are charged and kept on her. There are age-appropriate toys and equipment on the premises. The children enter facility from the front yard through the gate. The facility is a larger capacity licensee of 14. The facility does have a single action door handle for the front and back door exits. Front porch is off limits. Children are escorted in and out of the home by parent or licensee.
Napping: Children are provided napping daily. They use cots (4) with their own blankets to lay on the floor for napping or the couch. LPAs observed 2 play yards and 2 highchairs.
Transportation: Do not provide transportation.
Kitchen: Knives are kept in the kitchen in a high cabinet safety latched across from the refrigerator, inaccessible to children in care. Medication is kept in the kitchen in a safety latched high cabinet with knives inaccessible to children in care. Cleaning supplies and chemicals are kept under the kitchen sink with safety latch on it and in laundry closet with safety latch. Children with allergies is written on the child file. Licensee, states that there are no children with allergies.
NAME OF LICENSING PROGRAM MANAGER: Claretta Yates
NAME OF LICENSING PROGRAM ANALYST: Crystal Ali
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 05/21/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/21/2025
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: Ayala Family Child Care
FACILITY NUMBER: 147700001
VISIT DATE: 05/21/2025
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Fire Extinguisher: The required fire extinguisher (2A10BC) is reading in green and in located on the wall next to laundry closet last inspected 3/18/25. Fire alarm and carbon monoxide detectors were found to be in compliance, per Fire Marshall standards. Licensee stated that he came last year in June 2024. Fire and Disaster drills are conducted at least every six-months, last drills were recorded on 2/12/25 at 10am. LPAs observed the carbon monoxide tested 1:30pm, incompliance. The First Aid kit included a temperature thermometer, tweezer, scissors, gauzes, and cleansing pads/solution was observed to be complete and inaccessible to children kept high in closet up high on self.
Bathroom: The daycare bathroom down the hallway to the right. It has 1 sink, 1 toilet and 1 shower. Bathroom is clean and in good repair.
Outdoor Space Activity: The outdoor area is in the back yard. The front yard (porch area) is off limits. The back yard is free of broken toys/furniture & equipment, and other debris. There are plenty of toys for children to play with. There is a shed container to hold all small toys. There is a shade area due to multiple trees in the backyard. There are two off limit areas area in the backyard that are fenced. Per the Licensee, there is no smoking and no weapons on the premises.
Records/Documentation: LPAs reviewed with facility representative the LIC 311A, records to be maintained at the facility, for child’s records, personnel records, administrative records, and parent board. The child files (2) were reviewed and are in compliance. LPAs observed the licensee and assistant file to be incompliance. Licensee CPR/FA expire 1/25/27 and mandated reporter expires 8/8/26.
NAME OF LICENSING PROGRAM MANAGER: Claretta Yates
NAME OF LICENSING PROGRAM ANALYST: Crystal Ali
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 05/21/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/21/2025
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: Ayala Family Child Care
FACILITY NUMBER: 147700001
VISIT DATE: 05/21/2025
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Criminal Record Clearance - Family Child Care Homes
Licensee was reminded that all adults 18 and over living or working in the home, 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 licensed Family Child Care Home. 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.
Safe Sleep - Family Child Care Homes
LPAs discussed the safe sleep regulations with licensee 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 licensee 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) policy was discussed. For IMS information see PIN 22-02-CCP. When any IMS is provided, a Plan for Providing 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)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: https://www.ada.gov/resources/child-care-centers/.
NAME OF LICENSING PROGRAM MANAGER: Claretta Yates
NAME OF LICENSING PROGRAM ANALYST: Crystal Ali
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 05/21/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/21/2025
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: Ayala Family Child Care
FACILITY NUMBER: 147700001
VISIT DATE: 05/21/2025
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MyChildCarePlan.org – Family Child Care Homes
Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain childcare by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.
Megan’s Law - Family Child Care Homes
During the exit interview, the Licensee, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

No deficiencies were cited in accordance with Title 22 and health and safety codes. A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the licensee, Mirta Ayala.
NAME OF LICENSING PROGRAM MANAGER: Claretta Yates
NAME OF LICENSING PROGRAM ANALYST: Crystal Ali
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 05/21/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/21/2025
LIC809 (FAS) - (06/04)
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