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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197412222
Report Date: 03/19/2026
Date Signed: 03/19/2026 01:40:35 PM

Document Has Been Signed on 03/19/2026 01:40 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:CABRERA FAMILY CHILD CAREFACILITY NUMBER:
197412222
ADMINISTRATOR/
DIRECTOR:
CABRERA, GUADALUPEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(661) 965-1080
CITY:PALMDALESTATE: CAZIP CODE:
93552
CAPACITY: 14TOTAL ENROLLED CHILDREN: 25CENSUS: 3DATE:
03/19/2026
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:50 AM
MET WITH:Guadalupe CabreraTIME VISIT/
INSPECTION COMPLETED:
01:25 PM
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On March 19, 2026, Licensing Program Analyst (LPA) Joselito Del Mundo and Sara Rajapakse Montolla, conducted an unannounced Annual/Random Inspection. LPAs were greeted by Licensee, Guadalupe Cabrera who granted access and guided LPAs on a tour of the home. People who reside in the home are Licensee and her adult grandson who are live scanned and have TB skin test on file. The large family childcare home operates Monday-Sunday, 23 hours per day. LPAs reminded licensee that someone must be awake when the children are awake. At the time of the visit there were 3 children present with the licensee. Per Licensee, her assistants work when more children are present. During the visit one of the licensee’s assistants arrived. Incidental Medical Services (IMS) were discussed with the licensee. Per licensee, there are no children that need IMS at this time.

This is a two-story home with 4 bedrooms, 3 bathrooms, kitchen/dining room, family room (converted for childcare), and garage. Children have access to the childcare room, kitchen/dining room, the downstairs restroom near the stairs, a downstairs bedroom used for napping and the backyard. Off-limit areas of the home are the entire upstairs made inaccessible with a safety gate at the bottom of the stairs, and the garage made inaccessible with a key lock. LPAs observed a fireplace in the childcare room made inaccessible with stationary kitchen play set equipment. LPAs observed several cots and two cribs for napping. LPAs did not observe a swimming pool on the premises, but an aquarium (4ftx2ftx1ft) was located in the naping room. Per licensee, there are no pets on the premises and LPAs did not observe any pets in the home. LPAs observed several age-appropriate toys and activities in the childcare area and in the outdoor play space. The home was inspected inside for comfort, cleanliness, telephone service, heating, and ventilation. Medications are stored in an area inaccessible to children. The kitchen knives are stored in an upper kitchen cabinet made inaccessible to children with a safety lock. Cleaning compounds are stored in a lower kitchen cabinet made inaccessible to children with a safety lock.

NAME OF LICENSING PROGRAM MANAGER: Lady King
NAME OF LICENSING PROGRAM ANALYST: Joselito DelMundo
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 03/19/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/19/2026
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 6
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: CABRERA FAMILY CHILD CARE
FACILITY NUMBER: 197412222
VISIT DATE: 03/19/2026
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LPAs observed first aid kit is in a closet near the restroom inaccessible to children. Per licensee, there are no weapons or firearms in the home. LPAs did not observe any weapons or firearms. Smoke detectors and carbon monoxide detectors are in operable condition. The Fire Extinguisher is a 3A40BC and green. The napping room is also used as an isolation area for children with symptoms of illness. Parents are called immediately.The required posted documents were posted in the childcare area accessible to parents: Facility License, Notification of Parent's Rights Poster (PUB394), Emergency Disaster Plan (LIC610A) and Earthquake Preparedness Checklist (LIC9148), Mandated Reporter Certificate and CPR/First Aid Certificate.

Review of records to be maintained: LPAs reviewed with licensee the LIC 311D, Forms/Records To Keep In Your Family Child Care Homes, children’s forms/records, facility forms/records, and information to be posted. LPA reviewed three children’s files, licensee, and assistant’s files. Based on records review, the children’s files are complete. The licensees’ Pediatric CPR/First Aid expires 7.2027. Licensee’s assistants have valid First Aid/CPR and completed Mandater Reporter Training. The licensee has the required immunizations against pertussis (TDAP) and measles (MMR) and declination of influenza. The licensee completed the required Mandated Reporter training on 7.30.25. Orientation was completed.

LPAs observed current emergency disaster plan and the last fire drill completed on 2.13.26 at 4pm. Based on the facility roster, licensee has twenty five children enrolled in the day care.

The licensee and other adult residing or working in the home are fingerprint cleared. Based on the Guardian roster, LPAs verified that one adult who has a pending fingerprint clearance. Per Licensee, one of the children she cares was the adult with pending fingerprint clearance, who is currently 19 years old, and who went to the LiveScan operator on March 17, 2025. LPAs verified from the LIC279 Application for a Family Child Care (Large FCCH) dated 07/21/14 that licensee will be providing care for children ages zero to thirteen years of age.

LPAs advised the licensee not to care for the person who is 19 years pending background clearance while children are present. During this visit, Licensee provided LPAs with a copy of the updated LIC 279 to include a change in ages to be served.

The following was discussed with the licensee: Mandatory licensing forms for the children’s files, facility forms/records, and information to be posted in the family child care home; Requirements to conduct fire and

NAME OF LICENSING PROGRAM MANAGER: Lady King
NAME OF LICENSING PROGRAM ANALYST: Joselito DelMundo
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 03/19/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/19/2026
LIC809 (FAS) - (06/04)
Page: 3 of 6
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: CABRERA FAMILY CHILD CARE
FACILITY NUMBER: 197412222
VISIT DATE: 03/19/2026
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disaster drills once every six months and record it; Role and responsibilities of being a mandated reporter were reviewed; The licensee was reminded that 100% supervision is required at all times to children in care; Licensee was made aware that it is her responsibility to know the regulations as well as anyone who assists in providing care; Licensing must have the facility’s phone number at all times; if the phone number is changed, licensing must be notified; Regulation prohibits the smoking of any kind during the operation of the day care.

LPAs discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage athttps://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep as an additional resource. LPAs also informed licensee of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

The licensee was advised of the requirement to report Unusual Incidents. 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 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 licensee was informed to utilize the Unusual Incident Report/Injury Report LIC624B when submitting the report to the department.

Beginning on January 1, 2018, Assembly Bill 1207 (2015) requires all licensed providers, licensees, directors, and employees to complete training as specified on their mandated reporter duties and to renew their training every two years. Licensee must meet requirements as a precondition to licensure. 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.

NAME OF LICENSING PROGRAM MANAGER: Lady King
NAME OF LICENSING PROGRAM ANALYST: Joselito DelMundo
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 03/19/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/19/2026
LIC809 (FAS) - (06/04)
Page: 4 of 6
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: CABRERA FAMILY CHILD CARE
FACILITY NUMBER: 197412222
VISIT DATE: 03/19/2026
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Prior to making alterations or additions to a family childcare home or grounds, the licensee shall notify the Department of the proposed changed, including, but not limited to, the following: Conversion of a garage (either attached or detached) into a "childcare" room; Room additions to the family childcare home. Any change from an area of the family childcare home previously identified as "off limits" to an area where care and supervision will be provided to children in care. The licensee shall provide the Department with a copy of an inspection report when an inspection is required by the local building inspector as a result of the alteration, addition, or construction.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department. 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: https://www.ada.gov/resources/child-care-centers/.

Lead Flyer Requirement Health and Safety Code 1596.7996 mandated that effective January 1, 2019, CCC's and FCCH's are required to provide parents and guardians of children enrolling or reenrolling in care with written information on the risks and effects of lead exposure, blood lead testing requirements and recommendations, and options for locations of affordable blood lead tests as specified. A Lead

Poisoning Facts Flyer was created, in partnership with the California Department of Public Health (CDPH), to satisfy this requirement.

To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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/inspection-process.

Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain childcare by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California.

NAME OF LICENSING PROGRAM MANAGER: Lady King
NAME OF LICENSING PROGRAM ANALYST: Joselito DelMundo
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 03/19/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/19/2026
LIC809 (FAS) - (06/04)
Page: 5 of 6
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: CABRERA FAMILY CHILD CARE
FACILITY NUMBER: 197412222
VISIT DATE: 03/19/2026
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The licensee was advised it is her responsibility to visit the department's website to access licensing forms, Quarterly Updates and Provider Information Notices (PINs): www.ccld.ca.gov

LPA confirmed that there are no Registered Sex Offenders living in the facility and completed the RSO profile in FAS during the file review.

No deficiency was cited at this time. However, technical violation and technical advisories were issued during this visit.

This inspection visit was conducted in person. The report was read, and a copy was provided to the licensee, Guadalupe Cabrera. Notice of Site Visit was given and must remain posted for 30 days and Appeal Rights were given. Exit interview was conducted.

NAME OF LICENSING PROGRAM MANAGER: Lady King
NAME OF LICENSING PROGRAM ANALYST: Joselito DelMundo
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 03/19/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/19/2026
LIC809 (FAS) - (06/04)
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