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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 153808947
Report Date: 12/04/2025
Date Signed: 12/04/2025 03:20:02 PM

Document Has Been Signed on 12/04/2025 03:20 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:ROSAMOND CHILD DEVELOPMENT CENTERFACILITY NUMBER:
153808947
ADMINISTRATOR/
DIRECTOR:		NUNEZ, TINAFACILITY TYPE:
850
ADDRESS:2584 FELSITE AVETELEPHONE:
(661) 336-5236
CITY:ROSAMONDSTATE: CAZIP CODE:
93560
CAPACITY: 100TOTAL ENROLLED CHILDREN: 100CENSUS: 42DATE:
12/04/2025
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:28 AM
MET WITH:Tina Nunez, Site SupervisorTIME VISIT/
INSPECTION COMPLETED:
03:20 PM
NARRATIVE
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On December 04, 2025, Licensing Program Analyst (LPA) Isabel Ortega met with facility Site Supervisor 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 12/03/2025. This UIR was originally called in to the OD number on 11/26/2025 at 5:05 p.m. Palmdale office was closed and reopened on 12/01/2025.

Upon arrival, there were 42 children observed in care and 10 staff proving care and supervision. In addition, LPA toured the facility including the outdoor place area, LPA completed a safety inspection.

Incident occurred on 11/26/2025 at 12:20 p.m. during the Center's rest period, C1 was laying on her cot and stood up and complained to staff #1 about her ear. According to staff #1 C1 stated "There is a poky thing in my ear." C1 was crying and held her right ear with her hand. According to staff#1 a flash light was utilize and staff #1 was able to see a white object in C1's ear. C1's father was notified and came to the Center and picked up C1.

NAME OF LICENSING PROGRAM MANAGER: Lady King
NAME OF LICENSING PROGRAM ANALYST: Isabel Ortega
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 12/04/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/04/2025
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: ROSAMOND CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 153808947
VISIT DATE: 12/04/2025
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During this inspection LPA was provided with the facility roster, a photo, and C1's medical discharge report. LPA observed the area where the incident occurred and conducted interviews.

C1 was taken to Urgent Care, Urgent care referred C1 to a specialist to remove the foreign object from C1's ear. According to facility C1 returned to day care on 12/02/2025 with no restrictions. According to interviews conducted, staff #1, #2, #3 stated they did not witness C1 put the shell or object in her ear. interviews disclosed C1 was napping in classroom B by the science area at the time of the incident and three staff were present in the classroom.

According to medical report diagnosis C1 was observed with a white foreign body in the right ear completely obstructing the external auditory canal. Although, there were three staff in the classroom, staff did not have complete visual supervision during rest time. According to interviews conducted with staff, children, declarations collected and LPA's observation facility is cited a B citation for lack of adequate supervision. 101229 Responsibility for Providing Care and Supervision

According to facility sea shells in the science area have been removed in all classrooms A, B, and C.

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: 12/04/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/04/2025
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 12/04/2025 03:20 PM - It Cannot Be Edited


Created By: Isabel Ortega On 12/04/2025 at 02:52 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: ROSAMOND CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 153808947

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/04/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
01/04/2026
Section Cited
CCR
101229(a)(1)

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(a) The licensee shall provide care and supervision as necessary to meet the children's needs.(1)No child(ren) shall be left without the supervision of a teacher at any time... Supervision shall include visual observation. This requirement was not met by
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Facility will continue to complete daily safety inspections after each transition. Facility will also have a training regarding visual supervision and submit the sign in sheet with handouts reviewed/provided to the Palmdale Regional office by email by due date specified.
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Interviews and observation conducted by LPA. Staff #1, #2, and #3 were not able to witness C1 place the foreign object in ear. Although, there were 3 staff in classroom B at the time of the incident visual supervision was not met. which poses a potential health and safety health risk to children in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Lady King
NAME OF LICENSING PROGRAM MANAGER:
Isabel Ortega
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 12/04/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/04/2025


LIC809 (FAS) - (06/04)
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