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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197406879
Report Date: 08/27/2025
Date Signed: 08/27/2025 11:03:12 AM

Document Has Been Signed on 08/27/2025 11:03 AM - 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:PSD ECE OCOTILLO CENTERFACILITY NUMBER:
197406879
ADMINISTRATOR/
DIRECTOR:		DR. MELANIE CULVERFACILITY TYPE:
850
ADDRESS:38737 OCOTILLO SCHOOL DRIVETELEPHONE:
(661) 456-1347
CITY:PALMDALESTATE: CAZIP CODE:
93551
CAPACITY: 64TOTAL ENROLLED CHILDREN: 64CENSUS: 38DATE:
08/27/2025
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:45 AM
MET WITH:Joe Vega Smith, School Readiness CoordinatorTIME VISIT/
INSPECTION COMPLETED:
11:00 AM
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On August 27, 2025, Licensing Program Analyst (LPA) Annelise Villa met with School Readiness Coordinator Joe Vega Smith, for a Case Management Incident inspection involving an Incident Report dated August 20, 2025. Upon arrival, LPA observed 38 preschool children in care.

Description of the incident: On August 20, 2025, during meal time, Child #1 was getting up from the table and lose their footing. Child #1 fell backwards and hit the back of their head on a wooden cabinet. Staff #2 was sitting approximately 3 feet away. Staff #2 witnessed the incident but did not have enough time to catch the child. Staff #1 and Staff #2 attempted to offer the child first aid, however the child communicated he did not want to be touched. Prior to the incident, Staff #1 was on a phone call with Child #1's parent, and parent was made aware of the incident seconds after it took place. Child #1 was able to self soothe and returned to the table with Staff #2 within a couple minutes and resumed eating. Staff #2 stated she did not observe any active bleeding or lacerations on the head, however Child #1 would not allow staff to get a close look or provide first aid. Parent was able to be at the facility within 5-7 minutes and took child to receive outside first aid. Child returned on August 22, 2025, with a doctor note.

Based on interviews conducted with Staff, the facility took appropriate measures to ensure the health and safety of child #1. In response to the incident, staff participated in training on first aid procedures, implementing strategies to redirect students, and care/supervision. LPA obtained a copy of training materials. Facility complied with Title 22 regulations. No deficiencies have been cited at this time.

An exit interview was conducted and a copy of this report was read and provided to Joe Vega Smith, as well as a Notice of Site Visit.
NAME OF LICENSING PROGRAM MANAGER: Mariela Ramon
NAME OF LICENSING PROGRAM ANALYST: Annelise Villa
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 08/27/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/27/2025
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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