197750009-8-20-2026-12-CC-CALI-DX5SUB-20260820141051

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197750009
Report Date: 08/20/2026
Date Signed: 08/20/2026 02:11:36 PM

Document Has Been Signed on 08/20/2026 02:11 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:	CCRC EHS LPC		FACILITY NUMBER:	197750009
ADMINISTRATOR/ DIRECTOR:	ZAMORANO-PEDREGON, BEATRIZ		FACILITY TYPE:	830
ADDRESS:	2320 EAST AVE R		TELEPHONE:	(818) 717-1000
CITY:	PALMDALE	STATE: CA	ZIP CODE:	93550
CAPACITY: 52	TOTAL ENROLLED CHILDREN: 52	CENSUS: 14	DATE:	08/20/2026
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	12:15 PM
MET WITH:	Rosa Ayala, Center Director		TIME VISIT/ INSPECTION COMPLETED:	02:30 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	On August 20, 2026, Licensing Program Analyst (LPA) Crystal Ali conducted an unannounced annual random inspection. LPA met with Rosa Ayala, Center Director. LPA disclosed the purpose of the inspection to the Center Director. Present during today’s inspection were 14 Toddlers and 5 teachers. The facility's hours are Monday through Friday, 7:00AM-5:30PM. A waiver is on file for toddlers share the play yard with daycare children. Staffing Ratio and Capacity: Facility maintains an adequate teacher-child ratio. Care and supervision were evaluated and determined basic needs of children are appropriate and are being met. LPA observed sign in/out sheets in paper form and through ChildPlus App, and LIC 500. Incidental Medical Services (IMS) were discussed, and Center Director confirmed that there is two child who fit the IMS requirements. LPA observed cameras at entrance gates. There is a body of water on the premises. Physical Plant: The center is a single-story building. It has classrooms #1-#4, 2 bathrooms, kitchen, and two play yard areas.

Francisco Pedroza
Crystal Ali
	DATE: 08/20/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/20/2026

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: CCRC EHS LPC	FACILITY NUMBER: 197750009
	VISIT DATE: 08/20/2026

NARRATIVE

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Center Director informed LPA that classroom #1-#2 are not being used at this time due to the center having a pending application open with CCL to change the age range of classroom #1 & #2. LPA observed classroom #1 & #2 and bathroom not in use. All furniture and equipment were checked for age appropriateness and good repair. All classrooms are clean and safe. Telephone service was verified. Heating, lighting, and ventilation are adequate. Daily activities schedules were observed in the classroom. Drinking water (filtered water bottles stored in staff office and classrooms) is available inside and outside in the form of disposable plastic cups. All containers used for storing solid wastes, including moveable bins, shall have a tight-fitting cover that is kept on; they shall be leakproof and rodent-proof.
Kitchen: The facility does not have a kitchen that they utilize. There is a kitchen on the premises that is used by the Church. The facility gets meals and snacks delivered to the facility. There are refrigerators located in each classroom however CCRC has their own food program All kitchen areas/food preparation areas, and storage areas are kept clean and free of litter, rubbish, rodents, and other vermin. Storage containers for solid waste, including movable bins, shall have tight-fitting covers kept on and in good repair. The facility provides breakfast, lunch, and snacks daily. Chemicals and cleaning solutions are kept separate under the sink in each classroom inaccessible to children.
Bathroom: LPA observed each classroom to sharing a bathroom each. Each bathroom has four toilets, four sinks, and two changing tables. Staff restroom is in staff office (classroom #8). Each restroom has adequate toilet paper, hand soap, and paper towels available. Restrooms are cleaned, restocked with toiletries and sanitized by Janitor.

NAME OF LICENSING PROGRAM MANAGER: Francisco Pedroza
NAME OF LICENSING PROGRAM ANALYST: Crystal Ali
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 08/20/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/20/2026

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: CCRC EHS LPC	FACILITY NUMBER: 197750009
	VISIT DATE: 08/20/2026

NARRATIVE

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Medication: Children are inspected for illnesses and an overall wellness check. A review of medication policy indicated that prescription medication is administered only with the parent’s permission. The teacher and other administration staff administer medication and document the dosage, date, and time on a log. Medication stored in cabinet in locked backpack in each classroom next to sink. Medication is labeled correctly and stored in its original container. Medication is kept at the center until the expiration date and sent home with the parent for disposal. A review of medication policy indicated that prescription medication is administered only with the parent’s written permission. Required doctor note to pass out medication to the children. Currently there two children on prescribed medication and six children with food allergies. LPA observed and reviewed all medication and required documentation to be incompliance. Isolation area is in the staff office at the front of the facility. The child will be supervised by the staff until the parent arrives to pick them up.
Fire extinguisher: Fire/earthquake drills are current and completed every 6 months. Disaster drill completed on 4/7/26 (earthquake) and 4/21/26 (fire). A fire extinguisher is in the green located at each entrance of classroom (service last service 7/30/26), inaccessible to children mounted on the wall. Smoke detector and carbon monoxide detector are on the premises and in compliance with fire marshal standards. Center Director states fire Marshal completed in section on 6/29/26. The first aid kit was checked and contained all necessary items, including a manual, sterile dressings, bandages, adhesive tape, scissors, tweezers, a thermometer, and antiseptic solution. LPA observed a complete first aid kit located next to fire extinguisher in each classroom inaccessible to children.
Transportation: The facility does not provide transportation for the children.

NAME OF LICENSING PROGRAM MANAGER: Francisco Pedroza
NAME OF LICENSING PROGRAM ANALYST: Crystal Ali
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 08/20/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/20/2026

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: CCRC EHS LPC	FACILITY NUMBER: 197750009
	VISIT DATE: 08/20/2026

NARRATIVE

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Lead Testing/Drinking Water: Lead water testing completed 12/22/22. All levels were within range. Facility is currently using filtered drinking water that is purchased from the store to be used for drinking. The tap water in bathroom is used to wash hands only. There is no food being prepared at the facility.
Outdoor Activity Space: The outdoor play area was inspected and observed to be free of hazards, loose, or sharp objects. Equipment was inspected for safety, cushioning material, good repair and age appropriateness. The toddler play area (in front of classroom #3 & #4) has one large play equipment and several toys and three shaded areas. LPA observed inground swimming pools (2) located in front of classrooms #7 and #8 with regulated 5 ft. fencing, which includes a spring closure on the gate. Center Director states the swimming pool belongs to the other center (church) located on the same premises and that they do not have keys to access the pool area.
Records/Documentation: LPA reviewed with facility representative the LIC 125, records to be maintained at the facility, for children records (3), staff records (5), and parent board. LPA observed and reviewed three children’s records that are in compliance. LPA observed and reviewed six staff records that are in compliance.

No deficiencies cited in accordance with Title 22 of the California Code of Regulations and/or Health & Safety codes.

A notice of site visit was given and must remain posted for 30 days. A copy of this report and copy of appeal rights were provided to facility representative.

Exit interview conducted and report was reviewed with the Center Director, Rosa Ayala.

NAME OF LICENSING PROGRAM MANAGER: Francisco Pedroza
NAME OF LICENSING PROGRAM ANALYST: Crystal Ali
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 08/20/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/20/2026

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: CCRC EHS LPC	FACILITY NUMBER: 197750009
	VISIT DATE: 08/20/2026

NARRATIVE

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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.

Criminal Record Clearance - Child Care Centers
Facility representative was reminded that all adults 18 and over, 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 Child Care Center. 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.
Lead Testing – Child Care Centers (CCC)
CCC COMPLETED TESTING AND NO LEAD EXCEEDANCES:
Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care
Centers (CCCs) constructed before January 1, 2010, to test their water (used for
drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test. For child care center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1-CCP). LPA verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP.

NAME OF LICENSING PROGRAM MANAGER: Francisco Pedroza
NAME OF LICENSING PROGRAM ANALYST: Crystal Ali
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 08/20/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/20/2026

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: CCRC EHS LPC	FACILITY NUMBER: 197750009
	VISIT DATE: 08/20/2026

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Safe Sleep - Child Care Centers
LPA discussed the safe sleep regulations with facility representative and
discussed the Child Care Licensing Safe Sleep webpage at
https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep as an additional resource. LPA also informed 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.
Incidental Medical Services (IMS) - Child Care Centers
Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. When any IMS is provided, an updated Plan of Operation that includes 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) or (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-care-centers/.
PIN 22-05-CCP
MyChildCarePlan.org – Child Care Centers
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.

NAME OF LICENSING PROGRAM MANAGER: Francisco Pedroza
NAME OF LICENSING PROGRAM ANALYST: Crystal Ali
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 08/20/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/20/2026

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: CCRC EHS LPC	FACILITY NUMBER: 197750009
	VISIT DATE: 08/20/2026

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Subscribe to CCLD important information - Child Care Centers
Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platforms. To receive important licensed related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-carelicensing/
subscribe and select the Child Care option to receive email communication.

NAME OF LICENSING PROGRAM MANAGER: Francisco Pedroza
NAME OF LICENSING PROGRAM ANALYST: Crystal Ali
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 08/20/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/20/2026

LIC809 (FAS) - (06/04)

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