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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197416147
Report Date: 03/18/2026
Date Signed: 03/18/2026 04:22:30 PM

Document Has Been Signed on 03/18/2026 04:22 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:ROSS FAMILY CHILD CAREFACILITY NUMBER:
197416147
ADMINISTRATOR/
DIRECTOR:		KIMBERLY ROSSFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(661) 722-3891
CITY:LANCASTERSTATE: CAZIP CODE:
93536
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 0DATE:
03/18/2026
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:15 PM
MET WITH:Licensee Kimberly RossTIME VISIT/
INSPECTION COMPLETED:
04:30 PM
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On 3/18/2026, Licensing Program Analyst (LPA) Ana Rodriguez conducted an unannounced annual inspection at Ross Family Child Care. Upon arrival, LPA was greeted by the licensee, Kimberly Ross, who provided a facility tour. The home is occupied by 2 adults (the licensees and 1 daughter). No childcare children were present. According to Licensee no child care children are cared for in the home she only provide pickup and drop off. LPA did not observe any day care children in care. The licensee stated that the facility operates from 6:00AM-6:00 PM Monday through Friday. Incidental Medical Services (IMS) were discussed, and the licensee confirmed that children currently require IMS.
The home is set up as follows: This is a one–story house with 3 bedrooms, 2 bathrooms, a living room, a family room, a dining room, kitchen, laundry room, and a garage. There is an in-ground pool on the premises. The home was inspected for safety, comfort, cleanliness, telephone service, and ventilation. It has central heating and air conditioning, and all windows have screens free of cracks, bugs, and debris.
Main Area: The living room, family room, dining room and bedroom #1 are for childcare. Children can access the kitchen and bathroom #1.
Living room/Family room/Dining Room/Bedroom #1: LPA observed age-appropriate toys and furniture in the designated childcare areas. There is child-size furniture and several plastic storage bins containing games and toys for the children. The facility also has books available. An adult-size couch is present, and a TV is used to play educational videos for the children. A freeze dry machine is accessible to children from the dining room that will remain unplugged during day care hours.
Children's Bathroom (#1): The children’s bathroom is upon entry to the left on the right side of the hall. LPA observed that the toilet and faucets are clean and operable. The medication cabinet is free of medications or personal items. The bathroom was found to be clear of any hazardous items.
Kitchen: The kitchen was inspected for safety, and it was noted that hazardous items are not in reach of child care children.
NAME OF LICENSING PROGRAM MANAGER: Mariela Ramon
NAME OF LICENSING PROGRAM ANALYST: Ana Rodriguez
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 03/18/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/18/2026
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: ROSS FAMILY CHILD CARE
FACILITY NUMBER: 197416147
VISIT DATE: 03/18/2026
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There were no child safety latches on any of the kitchen cabinets. Sharp utensils, poisons, and medications are inaccessible to children. The kitchen was inspected for safety, and it was noted that hazardous items are kept out of children's reach. Sharp utensils, poisons, and medications are not accessible to children. Sharp knives are stored in a box inside the pantry.
Overnight care: According to the Licensee, overnight care will not be provided.
Off-limit: The front yard, bedroom #2 and 3, bathroom #2, backyard, laundry room and garage(key lock door knob) are inaccessible to the day-care children.
Backyard: Children do not use the back yard. Applicant has an alarm on French doors leading to the back yard that emit an audible sound when opened. The backyard is gated all around.
Additional Information
LPA observed an in-ground pool in the backyard. The wrought iron fences are constructed at least five (5) feet high. The bottom of the fence is no more than two (2) inches from the ground. The fence does not obscure the pool from view. LPA observed the gates swing away from the pool, self-close, and have a self-latching device no more than six (6) inches from the top of the gate. In addition, the following safety equipment is visible from the swimming pool and readily accessible for immediate use: A life ring with a minimum exterior diameter of 17 inches, approved by the United States Coast Guard. A rescue pole equipped with a body hook, with a minimum fixed length of 12 feet. A pool alarm that will sound upon detecting an entrance into the water and must be turned on and be in working condition during the FCCH’s operating hours while the swimming pool is not in use. Licensee must maintain and make available for the Department’s inspection, documentation verifying that the alarm meets the ASTM International Standard F2208. All licensed childcare centers and family care homes must inspect drowning prevention safety features and equipment daily before opening. A log of these inspections must be maintained and made available to the department upon request. Daily inspection logs must also be submitted to the Department upon request. Licensee was able to provide the daily log. The licensee understands and agrees that the swimming pool fencing will remain in place whenever licensed care is provided, so long as the fence makes the swimming pool inaccessible to children, as determined by licensing staff. No items around the perimeter of the fence would allow the fence to be climbable.

All unused electrical outlets are plugged and inaccessible to children. The licensee does not provide breakfast, lunch, or snacks. A required fire extinguisher (2A10BC) was observed in the kitchen. It is reading in the green zone, inaccessible to children, and meets standards established by the State Fire Marshal. The fireplace in the living room, it is screened and inaccessible to children.

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

DATE: 03/18/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/18/2026
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: ROSS FAMILY CHILD CARE
FACILITY NUMBER: 197416147
VISIT DATE: 03/18/2026
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 All window blind cords are secured and inaccessible to children. Detergents and cleaning compounds are stored in the off limits laundry room out of children’s reach, and medications are kept in an off-limits bedroom. Children will nap under adult supervision in designated areas like the family room. LPA observed 8 cots. The household has six small dogs (kept in kennel). Per licensee dogs will not interact with day care children. The home has a working cell phone. Combination smoke detector and carbon monoxide device located above the French doors leading to the backyard were tested at 3:33pm and found to be operable. The licensee does provide transportation for the children. They possess a valid California driver's license, vehicle insurance, and vehicle registration. Per the licensee, there are no weapons or firearms at the facility. LPA did not observe any weapons or firearms.
Documentation Review:

No Infants Enrolled: The licensee confirmed that no infants aged 0-24 months are enrolled.


Immunization Records: The licensee has up-to-date immunizations for MMR and DTaP, and both have submitted written statements declining the influenza vaccine.
CPR/First Aid: LPA verified that the licensee hold current Pediatric CPR and First Aid certification, which expires on 2/2027.
Mandated Reporter Training: The licensee completed the online mandated reporter training at www.mandatedreporterca.com, which expires on 1/2027.
Fire/Disaster Drill: The licensee does not conduct fire and disaster drills every six months due to children not being cared for at her home.
Required Postings: LPA observed that the licensee does have the Facility License, Emergency Disaster Plan, Earthquake Preparedness, and Parents' Rights Poster displayed as required.
The following information was discussed with the licensee:
-A baby walker shall not be allowed on the premises of a family child care home in accordance with Health and Safety Code sections 1596.848(b) and (c). State law prohibits baby walkers, bouncy seats, exersaucer, and other items that fall into that category.
-The licensee was advised of the requirement to report unusual incidents and/or injuries to the parent/guardian and Licensing within the time frame specified by the regulation and on the form LIC624B
-Licensee was advised to visit the CCL website (www.ccld.ca.gov) to obtain updates on courses and updates/changes to the regulations. Licensee was made aware that it is their responsibility to know the regulations as well as anyone who assists in providing care.
NAME OF LICENSING PROGRAM MANAGER: Mariela Ramon
NAME OF LICENSING PROGRAM ANALYST: Ana Rodriguez
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 03/18/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/18/2026
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: ROSS FAMILY CHILD CARE
FACILITY NUMBER: 197416147
VISIT DATE: 03/18/2026
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 The licensee was advised that the inaccessibility of hazards must be constantly reassessed depending on the children in care. Licensing must always have the facility's phone number; if the phone number is changed, licensing must be notified.
-Requirements for fire drills, earthquake drills, and documentation for both.
-The Duty Worker is available for questions Monday through Friday at (661) 202-3318 from 8:00 a.m. - 5:00 p.m.
-The licensee is reminded that 100% supervision is always required for children.
-The licensee was informed of the responsibility to report suspected Child Abuse by calling the Child Abuse Hotline at 1-800-540-4000. Also, contact the CCL office and follow up with a written Unusual Incident/Injury Report (LIC 624B).
-The regulation prohibits tobacco smoking in private residences that are licensed as family childcare homes and in those areas of the family childcare home where children are present (24/7 ban).
- LPA discussed the safe sleep regulations with licensee 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 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
- 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.
-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 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.
NAME OF LICENSING PROGRAM MANAGER: Mariela Ramon
NAME OF LICENSING PROGRAM ANALYST: Ana Rodriguez
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 03/18/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/18/2026
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: ROSS FAMILY CHILD CARE
FACILITY NUMBER: 197416147
VISIT DATE: 03/18/2026
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- During the exit interview, the Licensee Kimberly Ross, 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.

No deficiencies are being cited at this time.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the licensee Kimberly Ross.
NAME OF LICENSING PROGRAM MANAGER: Mariela Ramon
NAME OF LICENSING PROGRAM ANALYST: Ana Rodriguez
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 03/18/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/18/2026
LIC809 (FAS) - (06/04)
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