197406778-4-9-2026-12-CC-IORA-DSYVPC-20260409163631

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197406778
Report Date: 04/09/2026
Date Signed: 04/09/2026 04:38:49 PM

Document Has Been Signed on 04/09/2026 04:38 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:	LANCASTER-MARIPOSA ELEMENTARY STATE PRESCHOOL		FACILITY NUMBER:	197406778
ADMINISTRATOR/ DIRECTOR:	FOUNTAIN, KELLY		FACILITY TYPE:	850
ADDRESS:	737 W. AVENUE H-6		TELEPHONE:	(661) 942-8418
CITY:	LANCASTER	STATE: CA	ZIP CODE:	93534
CAPACITY: 48	TOTAL ENROLLED CHILDREN: 54	CENSUS: 40	DATE:	04/09/2026
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	11:45 AM
MET WITH:	Heidi Padillo, Lead Teacher		TIME VISIT/ INSPECTION COMPLETED:	04:45 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	On Thursday, 04/09/2026 Licensing Program Analyst (LPA), Isabel Ortega met with Lead Teacher, and conducted an Annual Random Inspection. LPA toured and inspected the facility in accordance to the facility sketch. During inspection LPA observed a total of 40 children in care and six staff providing care and supervision. Facility currently offers two morning sessions, one afternoon session and one full day care option. The center is located on a Unified School District- Lancaster school district. The hours of operation are 8:20 AM to 2:30 PM Monday through Friday and Part time care Monday to Friday 8:20 a.m. to 11:20 a.m Incidental Medical Services (IMS) were discussed. Facility consists of a total of two classrooms (Classroom 27 (PS1) and Classroom 28(PS2)), two children’s bathroom, one staff restroom, two kitchenette areas, and one outdoor play area. Staggered scheduled

NAME OF LICENSING PROGRAM MANAGER: Lady King
NAME OF LICENSING PROGRAM ANALYST: Isabel Ortega
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 04/09/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/09/2026

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: LANCASTER-MARIPOSA ELEMENTARY STATE PRESCHOOL	FACILITY NUMBER: 197406778
	VISIT DATE: 04/09/2026

NARRATIVE

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Child care center is clean, safe, sanitary and in good repair; all outdoor and indoor passageways, stair ways, incline, ramps, open porches and other areas of potential hazard are kept free of obstruction; floors of all rooms have a surface that is safe and clean, cleaning compounds inaccessible, poisons locked, furniture/equipment is good condition, free of flies, other insects, rodents; tables/chairs provided to meet children’s needs; all play equipment and materials used by children are age-appropriate, each child has an individual permanent or portable storage space (cubby, individually labelled with child's name) for his/her clothing, personal belongings and or bedding (stored separately). There is a working telephone.

A menu is available upon request and menu is posted in the kitchen area, in each classroom and by the entrance door. Food is prepared in the cafeteria and brought to the classroom. First Aid kit was observed with supplies (thermometer) readily available.

An isolation area takes place in each classroom by the rest area and a child blue couch is available for rest children's books are available. Children have the option for rest time and quiet time if needed a cots were observed in the full time option. Nap time is not including in the schedule for time care, but children have the option to rest as needed. Mats and cots are available.

Age-appropriate sinks and toilets were inspected for availability, toilets flush properly. Each restroom has adequate toilet paper, hand soap and paper towels available. Restrooms are cleaned, restocked of toiletries by staff as needed by on-site custodian disinfection and sanitizing are being completed daily. Children have the option for rest and relaxation at the library area when needed.

NAME OF LICENSING PROGRAM MANAGER: Lady King
NAME OF LICENSING PROGRAM ANALYST: Isabel Ortega
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 04/09/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/09/2026

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: LANCASTER-MARIPOSA ELEMENTARY STATE PRESCHOOL	FACILITY NUMBER: 197406778
	VISIT DATE: 04/09/2026

NARRATIVE

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LPA did not observed bodies of water on the premises. According to Facility there are no weapons nor guns at the facility. LPA did not observe any weapons or guns at the facility during the inspection.
The furniture and equipment were inspected for age appropriateness and good repair. Telephone service, heating, lighting, and AC ventilation were evaluated.

Facility sampled water for lead on 1/4/2023 and results were under 5.5 ppb, according to facility children are provided with purchased drinking water and children are provided with water from the dispenser and individual disposable cups are available. LPA observed a blue and white igloo in each classroom for outdoor use. LPA observed 5 gallon purchased water in each classroom.
Facility has all the required posted documents: Facility License, Notice of Parent's Rights Poster, Emergency Disaster Plan, Car seat safety and Earthquake Preparedness

First Aid supplies, smoke detectors, carbon monoxide (dual) were observed to be operating properly. The fire extinguisher (2A10BC) valve is reading in green; LPA observed a white tag dated 6/24/2025.

Trash cans with tight lids were observed. Food and snacks were inspected, and are properly labeled, stored, and within expiration date. According to the Facility they have emergency snacks available on site with the school district. Cleaning supplies are out of reach of children.

Emergency Drills are conducted every sixth month last drill was conducted and documented on 02/09/2026 at 02:15 p.m. (after noon part time and full day session) and at 9:00 a.m. (morning session).

NAME OF LICENSING PROGRAM MANAGER: Lady King
NAME OF LICENSING PROGRAM ANALYST: Isabel Ortega
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 04/09/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/09/2026

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: LANCASTER-MARIPOSA ELEMENTARY STATE PRESCHOOL	FACILITY NUMBER: 197406778
	VISIT DATE: 04/09/2026

NARRATIVE

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The outdoor play area was inspected and observed to be free of hazards, loose, or sharp objects. Equipment was inspected for safety, cushioning material, good repair. A technical violation was issued for broken child safety latch on the freezer containing sharp items. Facility replaced the broken child safety lock and made items inaccessible to children during inspection.

During outdoor play children have access to purchased water from an igloo container, white and blue with disposable cup is available. There is one shed in the outdoor back maintained key locked and utilized for arts, craft materials, toys and supplies.

Children's records were reviewed for completeness. Health History, Emergency contact and Medical Exams; Immunization Records are on a Hubbe database state preschool on line. The facility roster was up to date and all staff have been fingerprinted and association to the designated license number.

Facility provided a valid Pediatric CPR/First Aid from the American Red Cross valid until 7/19/2027. Childcare Provider Mandated Reporter training certificate is dated 07/14/2024 certificate is from Keenan Safe School. According to facility Mandated Reporter is taken yearly for all staff.

The following Incidental Medical Services (IMS) were discussed.
This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records.

NAME OF LICENSING PROGRAM MANAGER: Lady King
NAME OF LICENSING PROGRAM ANALYST: Isabel Ortega
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 04/09/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/09/2026

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: LANCASTER-MARIPOSA ELEMENTARY STATE PRESCHOOL	FACILITY NUMBER: 197406778
	VISIT DATE: 04/09/2026

NARRATIVE

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For IMS information see PIN 22-02-CCP. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514- 0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-carecenters/.
All staff are required to take the Child Care Provider Mandated Reporter (AB1207) training every 2 years. www.mandatedreporterca.com.

Upon hired date all staff are required to be immunized and show proof of immunization records according to Title 22 regulations.

Beginning on January 1, 2018, Assembly Bill 1207 (2015) requires all licensed providers, applicants, directors and employees to complete training as specified on their mandated reporter duties and to renew their training every two years. New employees shall have 90 days from date of employment to complete training as required. The training may be conducted at the following website www.mandatedreporterca.com. According to facility documentation all staff are aware they are mandated child abuse reporters and have the responsibility of reporting any suspected child abuse to the Child Abuse Hot line at (800) 540-4000.

For additional information and forms visit our website at: www.cdss.ca.gov

For updates on Community Care Licensing please visit the following website at: Childcareadvocatesprogram@dss.ca.gov
https://ccld.childcarevideos.org/

NAME OF LICENSING PROGRAM MANAGER: Lady King
NAME OF LICENSING PROGRAM ANALYST: Isabel Ortega
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 04/09/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/09/2026

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: LANCASTER-MARIPOSA ELEMENTARY STATE PRESCHOOL	FACILITY NUMBER: 197406778
	VISIT DATE: 04/09/2026

NARRATIVE

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Facility is aware all staff are mandated child abuse reporters, and all suspected child abuse shall be reporter to the child Abuse Hot-line 1800 LIC 9108 Child Abuse Acknowledgement was reviewed and signed by staff.

Per Title 22 Regulations facility is complying with rules and regulation, no deficiencies will be issued today. An exit Interview was conducted with facility Lead Teacher Heidi Padilla.

A copy of this Report, a Notice of Site Visit and appeal rights were provided on this day. A copy of this report must be made available to the public for 3 years. The Notice of site visit shall be visibly posted for 30 days.

NAME OF LICENSING PROGRAM MANAGER: Lady King
NAME OF LICENSING PROGRAM ANALYST: Isabel Ortega
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 04/09/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/09/2026

LIC809 (FAS) - (06/04)

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