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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197700948
Report Date: 03/12/2025
Date Signed: 03/12/2025 02:31:38 PM

Document Has Been Signed on 03/12/2025 02:31 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
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME:CORNEJO FAMILY CHILD CAREFACILITY NUMBER:
197700948
ADMINISTRATOR/
DIRECTOR:		NATHALY CORNEJOFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(323) 251-2763
CITY:LANCASTERSTATE: CAZIP CODE:
93536
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 0DATE:
03/12/2025
TYPE OF VISIT:PrelicensingANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:10 PM
MET WITH:Licensee/Nathaly CornejoTIME VISIT/
INSPECTION COMPLETED:
02:45 PM
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On March 12, 2025, Licensing Program Analyst (LPA) Carol Heath arrived at the facility and was greeted by Licensee Nathaly Cornejo. LPA was at the facility to conduct an announced pre-licensing inspection for a relocation and increase in capacity to care for up to 14 children. The operation hours are Monday to Sunday, 24 hours. LPA disclosed the purpose of the visit, and the licensee granted entry and provided a guided tour of the home. At the time of the inspection, LPA observed no children in care. The licensee’s Willman Zapeta and Rachel Mead were present during today’s inspection. The Incidental Medical Services (IMS) policy was discussed, and the licensee confirmed that IMS will not be provided at this time.
The licensee was initially licensed on January 11, 2024, as a Small Family Child Care Home. The Fire Department has inspected the facility and granted a fire clearance for up to 14 children, effective 2/17/2025.
The home is described as follows:
The facility is a two story family home with an attached garage. The home consists of a family room and a living room(designated as the primary daycare areas), kitchen, dining room, 5 bedrooms, 2.5 bathrooms. Care will primarily be provided in the children’s playroom, and the children will use the restroom located near the kitchen. The off-limits areas include 2nd floor bedrooms, kitchen, dining room, and the garage. There is no body of water on the premises.
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Carol Heath
LICENSING EVALUATOR SIGNATURE: DATE: 03/12/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/12/2025
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: CORNEJO FAMILY CHILD CARE
FACILITY NUMBER: 197700948
VISIT DATE: 03/12/2025
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Indoor:
Main area: Main care is provided in the living room and family room area. Children will eat in the living room / family room area. The daycare children will utilize the hallway bathroom on the right-hand side next to the garage. Children will use the backyard for outdoor play.
Living room: A fireplace in the Living room is screened to make it inaccessible to the children. LPA observed a safety latch in front of the fireplace, made inaccessible to children. PA observed many age-appropriate toys, books, and other materials in the Dining room area. Per the licensees, the children will nap in the Living Room.
Bathroom #1: Children will use bathroom #1 next to the family room. Bathroom #1 was toured and inspected. The toilet is in operable condition. The faucets are clean, safe, and operable. LPA reminded the licensee the children's bathroom must be free of shampoos, mouthwash, medication, perfumes, razors, air freshener, nail polish, and polish remover.
Outside: The backyard was inspected. The backyard is gated by a chain link fence on the side of the home. LPAs observed the outdoor air conditioner to be fully barricaded. The licensee states there is one dog on the premises.
Off-limit area: The areas include 2nd floor all bedrooms, the front yard, the kitchen, the laundry room, kitchen and the garage area.
Bedrooms (safety gate): The master bedroom, Bedroom #2-5 have a safety gate to make the rooms inaccessible to the children.
Bathroom #2 (Master Bathroom): Bathroom #2 is inside the master bedroom. LPA toured and inspected the bathroom. The toilet and sink are in operable condition.
Laundry (Safety gate): The clean supplies and poison are in the laundry room, which made inaccessible to children
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Carol Heath
LICENSING EVALUATOR SIGNATURE:

DATE: 03/12/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/12/2025
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
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: CORNEJO FAMILY CHILD CARE
FACILITY NUMBER: 197700948
VISIT DATE: 03/12/2025
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Kitchen/Dining (Safety gate): All sharp utensils, cutlery, cleaning supplies, medicines, drawers, cabinets with plastic bags, and pointy things or small things children can swallow; are inaccessible to children with a child safety latch under the kitchen sink. The refrigerator, dishwasher, stove, microwave, etc., are clean. The kitchen was clean, orderly, and free of hazardous items.
Garage (safety latch on the top): LPA inspected the garage. According to the licensee, the garage is off limit for children. No childcare activities will be conducted there.
Additional Information:
Bodies of water: According to the licensee, there were no bodies of water in the home. But a decorative water fountain did not have water.
An AC/Heating unit is located on the left side of the home and is inaccessible to children, with barrels blocking access. All unused electrical outlets are plugged and inaccessible to children. The licensee provides breakfast, lunch, and 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 is screened and inaccessible to children. All window blinds are cordless.
If a child shows signs of illness, they will be separated from other children and stay in family room. Detergents and cleaning compounds are stored in an under-kitchen cabinet, off 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 10 mats stored in the closet. The licensee does not provide overnight care at this time. The home has a working cell phone. All smoke detectors and carbon monoxide devices were tested and found to be operable. A fully stocked first aid kit, including a first aid manual, is inaccessible to children. The licensee will not provide transportation for the children. They possess a valid California driver's license, vehicle insurance, and vehicle registration. Per the licensee, there are no firearms at the facility. LPA did not observe any firearms.
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Carol Heath
LICENSING EVALUATOR SIGNATURE:

DATE: 03/12/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/12/2025
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
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: CORNEJO FAMILY CHILD CARE
FACILITY NUMBER: 197700948
VISIT DATE: 03/12/2025
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Documentation: The licensee has current CPR and First Aid Training with the expiration dates of 8/2025 and Prevented Health and Safety Training completed: on 08/2023. The licensee has her fingerprint clearance and TB exam. The licensee has proof of being immunized against influenza, pertussis, and measles. The licensee has proof of Mandated Reporting Training dated 2/12/2023. LPA shared LIC 311D with the licensee.
The following information was discussed with the licensee:
o A baby walker shall not be allowed on the premises of a family childcare 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.
o 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
o Licensee was advised to visit the CCL website (www.ccld.ca.gov) to obtain updates on courses and updates/changes to the regulations. The licensee was made aware that it is their responsibility to know the regulations and that of anyone who assists in providing care. 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.
o Requirements for fire drills, earthquake drills, and documentation for both.
o The Duty Worker is available for questions Monday through Friday at (661) 202-3318 from 8:00 a.m. - 5:00 p.m.
o The licensee is reminded that 100% supervision is always required for children.
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Carol Heath
LICENSING EVALUATOR SIGNATURE:

DATE: 03/12/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/12/2025
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
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: CORNEJO FAMILY CHILD CARE
FACILITY NUMBER: 197700948
VISIT DATE: 03/12/2025
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o 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).
o The regulation prohibits tobacco smoking in private residences licensed as family childcare homes and in areas where children are present (24/7 ban).
ü LPA discussed the safe sleep regulations with the 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 the licensee [or facility representative] 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.
ü 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.
ü IF A FACILITY IS CURRENTLY PROVIDING IMS, USE AS FOLLOWS: This facility provides Incidental Medical Services – IMS. LPA reviewed the storage of medication and equipment/supplies and reviewed children’s, personnel, and administrative records. 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 the publication: Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-carecenters/
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Carol Heath
LICENSING EVALUATOR SIGNATURE:

DATE: 03/12/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/12/2025
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
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: CORNEJO FAMILY CHILD CARE
FACILITY NUMBER: 197700948
VISIT DATE: 03/12/2025
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ü Centers and Family Child Care Homes 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.
ü Family Child Care Homes During the exit interview, the LICENSEE ****, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.
ü Family Child Care Homes A notice of site visit was given and must remain posted for 30 days.
ü 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 an email 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-carelicensing/ inspection-process.
ü
**As a result of this inspection, the home does meet Title 22 Regulations.

The licensee is pending the manager's review and approval.



An exit interview was conducted, and the report was reviewed with the licensee, Nathaly Cornejo.
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Carol Heath
LICENSING EVALUATOR SIGNATURE:

DATE: 03/12/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/12/2025
LIC809 (FAS) - (06/04)
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