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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197414307
Report Date: 04/20/2026
Date Signed: 04/20/2026 01:16:25 PM

Document Has Been Signed on 04/20/2026 01:16 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:MENENDEZ FAMILY CHILD CAREFACILITY NUMBER:
197414307
ADMINISTRATOR/
DIRECTOR:		MENENDEZ, MARIA A.FACILITY TYPE:
810
ADDRESS:TELEPHONE:
(661) 992-1224
CITY:LANCASTERSTATE: CAZIP CODE:
93536
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 4DATE:
04/20/2026
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:25 AM
MET WITH:Maria Carranza TIME VISIT/
INSPECTION COMPLETED:
01:30 PM
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On April 20th, 2026 at 10:30am, Licensing Program Analysts (LPAs) Evelyn Chacon and Crystal Ali conducted an unannounced/random inspection. LPAs met with Licensee’s Assistant #1 and spoke with Licensee Maria Menendez via telephone during inspection. Licensee stated she was not home and gave Assistant #2 permission to sign documents and to give a tour of home. At 11:46am, LPA Ali informed Licensee the importance of being present in the facility for 80% of the daily daycare operating hours. LPAs advised Assistant #1 on the purpose of the inspection. Licensee’s assistant provided LPAs a tour of the home inside and outside. There were four (4) children in care at the time of the inspection. LPAs verified all adults in the home have been background cleared. The day care is open from 5:00am to 4:00am Monday through Sunday.

Licensee has a two-story, 5-bedroom, 3-bathroom home with a kitchen, living room, formal dining room, laundry room, family room, and garage. Main care is provided in the living room, family room, classroom area near the front entrance, and playroom/game room. Children use the bathroom in the hallway right near the classroom area. They have access to the living room, family room, classroom, and playroom/game room. Off-limit areas include all bedrooms, the entire upstairs (barricaded by a safety gate), bathrooms #2 and #3 (upstairs), and the laundry room (upstairs). LPAs observed age-appropriate toys and furniture readily accessible inside childcare home. LPAs observed all proper posted documents in an accessible area of the home. Licensee stated they do not have firearms, ammo, or bodies of water on the facility. During the tour of the facility, Licensee observed a 2A10BC fire extinguisher to be in the green and located on the wall in kitchen. Fireplace was covered with two-play kitchen’s making it inaccessible to children in care. Licensee stated that the facility does not provide Incidental Medical Services (IMS).

NAME OF LICENSING PROGRAM MANAGER: Francisco Pedroza
NAME OF LICENSING PROGRAM ANALYST: Evelyn Chacon
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 04/20/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/20/2026
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: MENENDEZ FAMILY CHILD CARE
FACILITY NUMBER: 197414307
VISIT DATE: 04/20/2026
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Licensee stated if children are sick separate room will be used for isolation area. Any cleaning supplies, and poisonous items are kept in a locked area in of the kitchen, sharps and knives are kept out of reach of children in top cabinet in kitchen. A drawer in kitchen area was observed to be exposed with wood and metal exposed. At approximately 11:20am Assistant #2 confirmed that she transports the children. Assistant #2 provided her driver’s license which was observed to be current, insurance and registration was not observed. LPA Ali spoke to Licensee over the phone and Licensee confirmed insurance and registration was current and would send LPA Ali current insurance and registration on 4/21/26. Licensee stated she is in a food program, food program came to facility three weeks ago according to Licensee.

The outdoor area is enclosed with a brick wall all around. Shade is accessible and swing set is bolted to ground. LPAs observed age-appropriate toys and tricycles. Cobwebs were observed to be in one toy car and along toy kitchen where children play. There were holes in different parts of the outside play area. Licensee states the holes are from the previous shaded awning that is now removed. A part of the outdoor flooring was observed to be lifted and torn.

LPAs reviewed sampling of children and staff files and found one (1) infant file to be incomplete. The sampling of other children files were observed to be current. Licensee’s Mandated reporter certificate was current and expires 07/2027. Licensees Pediatric CPR/First Aide was current and expires 2/2027. Assistants Mandated reporter was current and expires 7/2027. Assistants Pediatric CPR/First Aide was current and expires 2/2027. Assistant #1 file was observed to not have immunization record. Assistant #2 does not have TB results on record. Emergency and disaster drills were conducted on 04/04/2026 at 9:30am.

Citations for this annual visit include Technical Violation for: missing C3 records, exposed wood and metal on drawer in kitchen, hole in couch in converted garage, astro turf lifting at the wall of the home, and cobwebs on children’s play equipment, and assistant files missing immunization records and TB records.

LPA conducted closing script and notice of site was given and must be posted within 30 days.

Licensee [or facility representative] 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.

NAME OF LICENSING PROGRAM MANAGER: Francisco Pedroza
NAME OF LICENSING PROGRAM ANALYST: Evelyn Chacon
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 04/20/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/20/2026
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: MENENDEZ FAMILY CHILD CARE
FACILITY NUMBER: 197414307
VISIT DATE: 04/20/2026
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LPA discussed the safe sleep regulations with licensee [or facility representative] and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and­ resources/safe-sleep as an additional resource. LPA also informed licensee [or facility representative] of the importance of checking for and removing any 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.
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/.
Licensee [or facility representative] was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

During the exit interview, the Licensee [name], confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

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.

Deficiency cited: (see LIC 809D) One Type B was cited in accordance to Title 22 of the California Code of Regulations and/or Health and safety codes.

A notice of site visit was given and must remain posted for 30 days.
Exit interview conducted and report was reviewed with the licensee [or facility representative] Irma Moses.
NAME OF LICENSING PROGRAM MANAGER: Francisco Pedroza
NAME OF LICENSING PROGRAM ANALYST: Evelyn Chacon
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 04/20/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/20/2026
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 04/20/2026 01:16 PM - It Cannot Be Edited


Created By: Evelyn Chacon On 04/20/2026 at 12:53 PM
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: MENENDEZ FAMILY CHILD CARE
FACILITY NUMBER: 197414307

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/20/2026

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102391(d)
Inspection Authority of the Department
(d) The licensee shall permit the Department to inspect, audit, and copy children's records or other family child care home records upon demand during normal business hours. Records may be removed if necessary for copying.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, interview, record review, the licensee did not comply with the section cited above in child #3 records were not available for audit which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 04/24/2026
Plan of Correction
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Licensse states that she will provide Child #3 records to LPA by 04/21/2026 via email or in person.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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.
Francisco Pedroza
NAME OF LICENSING PROGRAM MANAGER:
Evelyn Chacon
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 04/20/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/20/2026


LIC809 (FAS) - (06/04)
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