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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197401581
Report Date: 05/29/2026
Date Signed: 05/29/2026 12:24:05 PM

Document Has Been Signed on 05/29/2026 12:24 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:ANTELOPE VALLEY COLLEGE CHILD DEV. CENTERFACILITY NUMBER:
197401581
ADMINISTRATOR/
DIRECTOR:		ANGELICA ALVAREZFACILITY TYPE:
850
ADDRESS:3041 WEST AVENUE KTELEPHONE:
(661) 722-6500
CITY:LANCASTERSTATE: CAZIP CODE:
93536
CAPACITY: 60TOTAL ENROLLED CHILDREN: 60CENSUS: 4DATE:
05/29/2026
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:30 AM
MET WITH:Program Director Angelica AlvarezTIME VISIT/
INSPECTION COMPLETED:
12:30 PM
NARRATIVE
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On May 29, 2026, Licensing Program Analyst (LPA) Ana Rodriguez met with Program Director Angelica Alvarez who guided LPA on a tour of the facility. The purpose of this visit was to conduct a Case Management - Incident inspection regarding an incident that occurred on March 12, 2026. This Unusual Incident was self-reported by Angelica Alvarez Program Director. LPA discussed reporting requirements, pursuant to California Code of Regulations (CCR) Title 22, Section 101212(d), to ensure all reportable unusual incidents are reported within specified time frames. Upon arrival, LPA observed 4 preschool children in care, along with 3 teachers, 2 assistants and Program Director.

Description of incident: On March 12, 2026, at approximately 9:25 a.m., Child #1 informed Staff #1 that they had been running and fell. As a result of the fall, Child #1 sustained an injury to the mouth, requiring medical treatment. After reporting the injury to staff, Child #1 was provided first aid, and the parents were notified promptly. Confidential interviews revealed neither Staff #1 nor Staff #2 witnessed the incident. Staff failed to provide adequate care and supervision in accordance with California Code of Regulations (CCR), Section 101229, which requires that children remain under the supervision and visual observation of a teacher at all times. Due to the lack of supervision, Child #1 sustained an injury while in care without staff observation, posing an immediate risk to the health and safety of children in care. This is a type A citation. Staff are encouraged to participate in training videos that can be found at https://ccld.childcarevideos.org/child-care-center-operators/.

SEE 809C
NAME OF LICENSING PROGRAM MANAGER: Mariela Ramon
NAME OF LICENSING PROGRAM ANALYST: Ana Rodriguez
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 05/29/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/29/2026
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 4
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: ANTELOPE VALLEY COLLEGE CHILD DEV. CENTER
FACILITY NUMBER: 197401581
VISIT DATE: 05/29/2026
NARRATIVE
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LPA Rodriguez introduced the Childcare Technical Support Program (TSP) and informed the facility representatives that TSP is a voluntarily program to assist facilities with meeting and maintaining the requirements of operating a licensed childcare facility. LPA will refer the facility for services.

Deficiencies cited: (See LIC 809D). The following Type A deficiency is being cited in accordance with Title 22 of the California Code of Regulations and/or Health & Safety codes:101229(a)(1) Responsibility for Providing Care and Supervision The licensee shall provide care and supervision as necessary to meet the children's needs. No child(ren) shall be left without the supervision of a teacher at any time, except as specified in Sections 101216.2(e)(1) and 101230(c)(1). Supervision shall include visual observation.

LPA Ana Rodriguez informed facility representative Program Director Angelica Alvarez that this report dated May 29, 2026 documents 1 Type A citation which shall be posted for 30 consecutive days as there is/are immediate risk(s) to the health, safety, or personal rights of children in care.
Also, LPA Ana Rodriguez informed the facility representative to provide a copy of this licensing report dated May 29, 2026 that documents any Type A citation to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

An exit interview was conducted and a copy of this report was provided to the Program Director Angelica Alvarez, along with a Notice of Site Visit and appeal rights.

SEE 809D
NAME OF LICENSING PROGRAM MANAGER: Mariela Ramon
NAME OF LICENSING PROGRAM ANALYST: Ana Rodriguez
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 05/29/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/29/2026
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 05/29/2026 12:24 PM - It Cannot Be Edited


Created By: Ana Rodriguez On 05/29/2026 at 11:50 AM
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: ANTELOPE VALLEY COLLEGE CHILD DEV. CENTER
FACILITY NUMBER: 197401581

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/29/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
05/29/2026
Section Cited
CCR
101229(a)(1)

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Responsibility for Providing care and Supervision 101229(a)(1): No child(ren) shall be left without the supervision of a teacher at any time…(including) visual observation. This was not met as evidence by:
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POC: Staff shall participate in training on topics that include care and supervision, teacher-child ratios, and personal rights. Director shall document training and send proof of completion to LPA no later than June 5, 2026.
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Based on interviews , lack of supervision resulted in Child #1 sustaining an injury and staff were not providing visual observation. This poses an immediate health and safety 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.
Mariela Ramon
NAME OF LICENSING PROGRAM MANAGER:
Ana Rodriguez
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 05/29/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/29/2026


LIC809 (FAS) - (06/04)
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