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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197700978
Report Date: 08/06/2025
Date Signed: 08/06/2025 02:48:00 PM

Document Has Been Signed on 08/06/2025 02:48 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:SAGASTUME FAMILY CHILD CAREFACILITY NUMBER:
197700978
ADMINISTRATOR/
DIRECTOR:		NORMA SAGASTUMEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(661) 743-8020
CITY:LANCASTERSTATE: CAZIP CODE:
93536
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 0DATE:
08/06/2025
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:15 PM
MET WITH:Norma SagastumeTIME VISIT/
INSPECTION COMPLETED:
03:00 PM
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On 8/6/2025, Licensing Program Analyst (LPA) Carol Heath announced a pre-licensing inspection with the applicant, Norma Sagastume, to ensure the facility meets licensing requirements. The licensee is requested to provide care for a large family childcare home with a capacity of 14 children. LPA toured the house in and out. Individuals who reside in the home include 2 adults (the applicant and her daughter) and 0 children. Per Guardian, all adults in this facility obtain a criminal record clearance. During today's inspection, there were 0 children with the licensee. The hours of operation are Monday through Friday, 6:00 am to 6:00 pm. The incidental Medical Services (IMS) policy was discussed. The licensees will not provide the IMS at this time.
The home is described as follows:
This two-story home consists of a 5-bedroom, 3-bathroom home with a kitchen, office, family room, living/dining room, laundry, and garage. There is no body of water on the premises. Childcare children can access the backyard and kitchen.
Indoor:
Main area: Main care is provided in the family used for childcare. Children use the bathroom on the left in the hallway.
NAME OF LICENSING PROGRAM MANAGER: Claretta Yates
NAME OF LICENSING PROGRAM ANALYST: Carol Heath
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 08/06/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/06/2025
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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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: SAGASTUME FAMILY CHILD CARE
FACILITY NUMBER: 197700978
VISIT DATE: 08/06/2025
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· Family room: The fireplace in the family room is covered to prevent children from accessing it. LPA observed many age-appropriate toys, books, and other materials in the dining room area. According to the applicant, the children will nap in the family room.
· Bathroom #1: Children will use bathroom #1 next to the family room. Bathroom #1 was toured and inspected. The toilet is in working condition. The faucets are clean, safe, and operational; the bathtub and shower area are free of hazards. There is no medication stored in the medicine cabinet. The licensees installed a safety latch under the sink cabinet to keep the materials inaccessible to children.
· Kitchen/ Formal Dining (off-limits): All sharp utensils, cutlery, cleaning supplies, medicines, drawers, cabinets with plastic bags, and pointy or small items children could swallow are kept inaccessible to children with child safety latches under the kitchen sink cabinets. The refrigerator, dishwasher, stove, microwave, etc., are clean. The kitchen was clean, organized, and free of hazards. Medications were stored in the off-limits bedroom.
· Outside: The backyard was inspected. The backyard is completely fenced (wood). LPA observed age-appropriate toys and equipment. The applicant will need to ensure all wires (water or blinds) cords are inaccessible to the children. The applicant was reminded to supervise children at all times while playing in the backyard.

Off-limit area: The areas include all bedrooms (upstairs and downstairs), bathroom #2, pantry, kitchen, laundry (safety knob), and garage.


· Bedrooms (Safety doorknobs or key lock): The master bedroom, Bedroom #2, has safety doorknobs to make the room inaccessible to the children.
· Bathroom #2 (Master Bathroom): Bathroom #2 is inside the master bedroom. LPA toured and inspected the medicine cabinet. The toilet and sink are in operable condition.
NAME OF LICENSING PROGRAM MANAGER: Claretta Yates
NAME OF LICENSING PROGRAM ANALYST: Carol Heath
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 08/06/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/06/2025
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: SAGASTUME FAMILY CHILD CARE
FACILITY NUMBER: 197700978
VISIT DATE: 08/06/2025
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· Laundry (Safety doorknob): The clean supplies and poison are in the laundry room. There is a safety doorknob on the garage door, which makes it inaccessible to children
· Garage (safety doorknob): LPA inspected the garage. According to the licensee, the garage is off-limits for the children. No childcare activities will be conducted there.
Other:
The AC/Heating Unit and swamp cooler were observed. The AC/Heating Unit is located on the right side of the home and is inaccessible to children due to barrels blocking access. Bodies of water: Before the licensee arrived, there were no bodies of water in the home. There is a decorative water fountain that has no water. Electrical outlets: All unused electrical outlets are plugged and inaccessible to children. Food: The licensee will enroll in the Food program and provide breakfast, lunch, and two snacks. Fire extinguisher (2A10BC): The LPA observed a fire extinguisher (2A10BC) that is charged and located in the childcare area, inaccessible to children. It meets the standards set by the State Fire Marshal. Hanging window blind cords: The cords are out of reach of children. Isolation area (Illness): According to the licensee, if a child shows signs of illness, they will be separated from other children and stay in the childcare area (library). Medications and cleaning solutions: Detergents and cleaning compounds are stored in the under-kitchen cabinet with a safety lock, making them inaccessible to children. Medications are stored in the bedroom and are off-limits. Napping: Children will nap in designated areas under adult supervision. The LPA observed 16 cats in the closet. Overnight Care: The licensee stated that the facility does not provide overnight care. Pets: There are no pets on the premises. Phone service: A working landline and cell phone are available. Smoke detectors and carbon monoxide detectors: The devices tested were operable.
NAME OF LICENSING PROGRAM MANAGER: Claretta Yates
NAME OF LICENSING PROGRAM ANALYST: Carol Heath
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 08/06/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/06/2025
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: SAGASTUME FAMILY CHILD CARE
FACILITY NUMBER: 197700978
VISIT DATE: 08/06/2025
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The First Aid kit, located in the childcare area, is inaccessible to children. It was observed to be complete with supplies and a manual. Transportation: The licensee will provide transportation for children and have a valid California driver's license, vehicle insurance, and registration. Weapons or Firearms: The licensee stated there are no firearms at the facility at this time. The LPA did not observe any firearms.
Documentation:
The licensee has current CPR and First Aid Training with the expiration dates of 05/2027 and Prevented Health and Safety Training completed on 6/8/2025. 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 that will expire in 2027. LPA shared LIC 311D with the licensee.
The following was discussed with the licensee:
o 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.
o Discuss the Safe Sleep Proposed Regulations with the licensee. Safe Sleep: 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 [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.
NAME OF LICENSING PROGRAM MANAGER: Claretta Yates
NAME OF LICENSING PROGRAM ANALYST: Carol Heath
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 08/06/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/06/2025
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: SAGASTUME FAMILY CHILD CARE
FACILITY NUMBER: 197700978
VISIT DATE: 08/06/2025
NARRATIVE
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o Capacity requirements, Roster requirements, Posting requirements, and Documentation requirements for disaster drills (fire and earthquake). Mandatory Forms for the children's and provider's files and Safe Sleep Awareness. The role and responsibilities of being a mandated reporter were reviewed. The licensee was reminded that supervision is always required for children in care.
o Criminal Record Statement: The licensee [or facility representative] was reminded that all adults 18 and over living or working in the home, including employees and volunteers, must obtain a criminal record clearance or exemption or transfer their existing clearance or exemption prior to the initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.
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.
o Licensee was made aware that it is their responsibility to know the regulations as well as 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 Mandatory Forms for the children's files and provider's files.
o Notice of Site Visit: A notice of site visit was given and must remain posted for 30 days.
NAME OF LICENSING PROGRAM MANAGER: Claretta Yates
NAME OF LICENSING PROGRAM ANALYST: Carol Heath
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 08/06/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/06/2025
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: SAGASTUME FAMILY CHILD CARE
FACILITY NUMBER: 197700978
VISIT DATE: 08/06/2025
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o Our Quarterly updates come out every 3 months. They are also now in Spanish. Please log in to the CCLD website, or you can email our advocates to have the quarterly updates sent directly to your email. Child Care Advocates information: www.childcareadvocatesprogram@cdss.ca.gov
o Posting Requirements: Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
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 required for children at all times.
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, call the CCL office and follow up with a written Unusual Incident/Injury Report (LIC 624B).
o The regulation prohibits the smoking of tobacco in a private residence that is licensed as a family childcare home and in those areas of the family childcare home where children are present (24/7 ban).

**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 applicant, Norma Sagastume.
NAME OF LICENSING PROGRAM MANAGER: Claretta Yates
NAME OF LICENSING PROGRAM ANALYST: Carol Heath
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 08/06/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/06/2025
LIC809 (FAS) - (06/04)
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