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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 192006365
Report Date: 08/19/2025
Date Signed: 08/19/2025 04:18:42 PM

Document Has Been Signed on 08/19/2025 04:18 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 CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME:LANCASTER-LINDA VERDE ELEMENTARY STATE PRESCHOOLFACILITY NUMBER:
192006365
ADMINISTRATOR/
DIRECTOR:		FOUNTAIN, KELLYFACILITY TYPE:
850
ADDRESS:44924 N. 5TH STREET EASTTELEPHONE:
(661) 942-5862
CITY:LANCASTERSTATE: CAZIP CODE:
93535
CAPACITY: 48TOTAL ENROLLED CHILDREN: 48CENSUS: 21DATE:
08/19/2025
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:30 PM
MET WITH:Esperanza Montes, Lead Teacher and Director Kelly FountainTIME VISIT/
INSPECTION COMPLETED:
04:17 PM
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On August 19, 2025, at 12:30 P.M., Licensing Program Analyst (LPA) Joselito L. Del Mundo met with the Lead Teacher, Esperanza Montez (staff 1) to conduct an unannounced Annual/Random inspection for the preschool license in accordance with the facility sketch. Shortly after, Director Kelly Fountain, Nurse Practitioner Tessiny Holliday (staff 2), and LVN Diana Barragan arrived at the facility. A tour of the facility was conducted. LPA observed a total of 21 preschool children in two classrooms (PS 2 and PS 5) with 6 staff providing care and supervision. The PS 2 classroom has two sessions and operates Monday to Friday, from 8:30 A.M. to 11:30 A.M. for the first session, and 12:30 P.M. to 3:30 P.M. for the second session. The PS 5 classroom operates on a full day schedule from Monday to Friday, between 8:00 A.M. to 2:15 P.M.

Indoor/Children’s Area:
The room is clean, safe, sanitary and in good repair; the entrance and exit doors of the classroom is kept free of obstructions; floors of the room have a surface that is safe and clean, teachers used spray bottles disinfectants to sanitize rooms, furniture/equipment is in good condition and is free of flies, other insects, and rodents; tables/chairs provided to meet children’s needs. LPA observed central AC/heater and vents on side top wall. LPA observed the thermostat located in the classrooms and observed the temperature to be 71 and 68 degrees. The staff stated that rooms are being sanitized three times daily. All play equipment and materials used by children are age-appropriate, each child has an individual storage space (cubby, individually labelled with name) for his/her clothing, personal belongings. There is a working telephone. Electrical outlets are inaccessible and have plastic safety plugs. Recalled and or prohibited toys or sleep/play equipment were not observed on the premises. There are no window cords accessible to children.


Trash bins have tight fitting lids. Water dispenser is available in the classrooms. All materials and surfaces
NAME OF LICENSING PROGRAM MANAGER: Lady King
NAME OF LICENSING PROGRAM ANALYST: Joselito DelMundo
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 08/07/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/19/2025
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: LANCASTER-LINDA VERDE ELEMENTARY STATE PRESCHOOL
FACILITY NUMBER: 192006365
VISIT DATE: 08/19/2025
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are toxic free. There is no fireplace in the facility. The center has an internal pull-down fire alarm system and 2-A:10-B:C type of fire extinguishers. Carbon monoxide devices are in operable condition (tested at 1:10 P.M.)

Restrooms: LPA inspected and observed two toilets and one sink in each of the classrooms. LPA also observed liquid soap, paper towel, toilet paper, and trash bins with lids. LPA also observed 2 sinks outside of the bathrooms. Water temperature is appropriate. The quiet area is used as an isolation area for children who become ill while in care and children sit on little couches. The facility maintains a comfortable temperature at all times, first aid supplies (first aid manual/guide, bandages, scissors, tweezers), electronic sign in/out sheets available and completed daily. Smoking is prohibited on the premises, daily inspection for illness, no prohibited child care items observed. Firearms/weapons are not allowed or stored on premises. There is no body of water on the premises.



Per staff, children enrolled in PS 2 do not nap inside the classroom. Sleeping mats/cots were observed during this inspection in the PS 5 classroom.

Outdoor: The facility has one playground area for preschool children. The play area is made of turf grass and has a canopy to cover other play equipment. Outdoor play equipment was inspected for health, safety, good repair, and age appropriateness. The area was observed to be free of debris, free from hazard, holes, broken items, debris. Drinking water is provided using water jugs. LPA observed toy house, slide, little climbing rope, and tricycles. There is also a bicycle path on the play area. LPA observed the play structure equipment to be age-appropriate ages 2-5 and areas around or under high climbing equipment, are cushioned with artificial turf. For adequate shade, the facility has a hip roof shade structure. For outdoor water drinking, staff will be bringing out water jugs to refill children's cups. No bodies of water were observed.

Teacher child ratios were observed, and staff name recorded. Care and supervision was evaluated to determine if the basic needs of children are met and appropriate.



Health Related Services: According to the staff, the lead teacher in classroom PS 2 and all three staff in
NAME OF LICENSING PROGRAM MANAGER: Lady King
NAME OF LICENSING PROGRAM ANALYST: Joselito DelMundo
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 08/19/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/19/2025
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 CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: LANCASTER-LINDA VERDE ELEMENTARY STATE PRESCHOOL
FACILITY NUMBER: 192006365
VISIT DATE: 08/19/2025
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classroom PS 5 are the designated personnel to administer prescription medications with the parents’ consent and document the dosages, date, and the time the medications were administered. The staff showed LPA the log on sheet for the medications. The staff will document when the medication is administered. All medications are stored in a locked cabinet inside the classroom.

Children are inspected for illnesses (wellness policy) as they arrive. Per staff, at this no medications are provided to preschool children. If medications are administered, they would be provided only with parent's written permission and a doctor's note. Facility was advised that the medication must be properly labeled and stored in its original container.

This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226.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: http://www.ada.gov/childqanda.htm

Director Fountain stated that they were not providing transportation to children in care.



Food Service: The facility has monthly menu posted on the parent board. The center provides meals and snacks through the school

Staff/Personnel Records: Designation of Responsibility observed, immunization's, TB clearance, health screening, criminal record statement, statement acknowledging requirement to report suspected child abuse, CPR/First Aid and mandated reporter trainings were completed and are current.



Facility Records: Electronic Roster, fire/disaster drills log was completed last August 15, 2025, at 8:30 A.M.

Posting Requirements: Failure to comply with posting requirements shall result in an immediate civil
NAME OF LICENSING PROGRAM MANAGER: Lady King
NAME OF LICENSING PROGRAM ANALYST: Joselito DelMundo
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 08/19/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/19/2025
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 CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: LANCASTER-LINDA VERDE ELEMENTARY STATE PRESCHOOL
FACILITY NUMBER: 192006365
VISIT DATE: 08/19/2025
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penalty. The following were observed posted as required: facility license, Personal Rights (LIC613A), Parent’s Rights Poster (PUB 394), emergency disaster plan, earthquake preparedness checklist, and California Car Seat Law.

Documents Provided and or Discussed: Forms and records to keep at the facility and IMS.

Advisory/Other: First Aid kit was observed with supplies (thermometer) readily available.

According to the staff, parents use electronic Sign in and out sheets when dropping off and picking up their child. The parent board was reviewed and has all the required forms posted. Fire/earthquake drills current. The facility has a daily schedule posted inside the classroom.

Director Kelly Fountain was advised of the requirement to report Unusual Incidents. Licensee informed to utilize the Unusual Incident Report/Injury Report LIC624B when submitting the report to the department (email address on the website: www.unusualincidentreport@dss.ca.gov). A report shall be made to the department by telephone or fax during the department's normal business hours before the close of the next working day following the occurrence during the operation of the family day care home. In addition, a written report shall be submitted to the department within seven days following the occurrence of any events specified above.



The director was also reminded that all adults 18 and over, including employees and volunteers, 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 up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

Any duly authorized officer, employee, or agent of the Department shall, upon presentation of proper identification, shall inspect the facility. The Director shall permit the Department to inspect the family child care home, and to privately interview children or staff, to determine compliance with or to prevent violations of child care center or regulations, also enter and inspect any place providing personal care, supervision and services at any time, with or without advance notice, to secure compliance with, or to prevent a violation.
NAME OF LICENSING PROGRAM MANAGER: Lady King
NAME OF LICENSING PROGRAM ANALYST: Joselito DelMundo
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 08/19/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/19/2025
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 CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: LANCASTER-LINDA VERDE ELEMENTARY STATE PRESCHOOL
FACILITY NUMBER: 192006365
VISIT DATE: 08/19/2025
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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

No deficiencies were cited during this inspection.

A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100. The On 8Duty Worker is available for questions at (661) 202-3318 Monday through Friday 8am-5pm.



Exit interview conducted and a copy of this report, Notice of Site Visit, and appeal rights were provided to Director Kelly Fountain.
NAME OF LICENSING PROGRAM MANAGER: Lady King
NAME OF LICENSING PROGRAM ANALYST: Joselito DelMundo
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 08/19/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/19/2025
LIC809 (FAS) - (06/04)
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