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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 150404109
Report Date: 09/08/2025
Date Signed: 09/08/2025 10:11:43 PM

Document Has Been Signed on 09/08/2025 10:11 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 CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME:LAMONT CHILD DEVELOPMENT CENTERFACILITY NUMBER:
150404109
ADMINISTRATOR/
DIRECTOR:		CINDY DIAZFACILITY TYPE:
850
ADDRESS:9615 MAIN STREETTELEPHONE:
(661) 845-1015
CITY:LAMONTSTATE: CAZIP CODE:
93241
CAPACITY: 72TOTAL ENROLLED CHILDREN: 72CENSUS: 14DATE:
09/08/2025
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:18 PM
MET WITH:Rosalinda Aroyo, Teacher DesigneeTIME VISIT/
INSPECTION COMPLETED:
02:30 PM
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On September 08, 2025, Licensing Program Analyst (LPA) Isabel Ortega met with Teacher Designee to conduct an unannounced case management inspection. The purpose of this case management is to follow up on a self reported unusual incident report (UIR) submitted to the Department on 09/04/2024. The unusual incident report is regarding child #1 sustaining an injury during outdoor play.

Upon arrival, there were 14 children observed in care and 5 staff proving care and supervision.

During this inspection LPA was provided with the facility roster, incident report and KCSOS Early Childhood Education Center Locations. LPA toured the two classrooms. In addition, LPA completed a safety inspection of the facility and outdoor play including the equipment.

According to interviews conducted with staff and LPA’s observation. LPA observed the classrooms to be clean and orderly. LPA also observed the area where the incident occurred. According to facility child #1 was playing on the portable basketball hoop and went to get the ball under the net and stood up quickly while still under the basketball hoop and hit the top of his head on the ring. According to staff child did not cry and continued playing, Initially staff checked child since they witnessed Child #1 hit his head but no reaction. Child #1 continued on to ride the tricycles for the remaining of the recess.

According to staff as the children were walking back to the classroom staff #3 noticed blood on child#1's hair. Facility applied First Aid, utilizing an ice pack.

NAME OF LICENSING PROGRAM MANAGER: Lady King
NAME OF LICENSING PROGRAM ANALYST: Isabel Ortega
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 09/08/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/08/2025
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 CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: LAMONT CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 150404109
VISIT DATE: 09/08/2025
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Parent was notified; a doctor’s note was submitted to the facility stating child was seen and medical glue was applied. According to facility child returned to the facility for care the following day.

According to facility and record review this incident occurred on 9/4/2024, staff and child #1 no longer are at the facility.

No citation was issued at this time, facility notified parent, according to facility the incident was witnessed by staff and two staff were outside providing care and supervision, and CCL was notified in a timely manner. It was determine child #1 accidentally hit his head on the basketball hoop and two staff were outside with children when incident occurred.

A notice of site visit was provided and requested to be posted for 30 days.

An exit interview was conducted, a copy of this report, notice of site visit and appeal rights were provided to facility.

NAME OF LICENSING PROGRAM MANAGER: Lady King
NAME OF LICENSING PROGRAM ANALYST: Isabel Ortega
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 09/08/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/08/2025
LIC809 (FAS) - (06/04)
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