197750009-9-26-2025-12-CC-JTAO-DLVTTK-20250926150051

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197750009
Report Date: 09/26/2025
Date Signed: 09/26/2025 03:01:10 PM

Document Has Been Signed on 09/26/2025 03:01 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:	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: 0	DATE:	09/26/2025
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	11:28 AM
MET WITH:	Rosa Ayala-Lopez, Director		TIME VISIT/ INSPECTION COMPLETED:	03:11 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 9/26/2025, Licensing Program Analyst (LPA) Justeene Tamayo met with Director Rosa Ayala Lopez, to conduct an unannounced Annual inspection of the infant program. LPA disclosed the purpose of the inspection and was granted entry to the facility. The Center will also incorporate a Toddler option. Each component will maintain a physical separation (indoors and outdoors) at all times. The center consists of 4 classrooms. There are only 2 classrooms operating at this time. The Center operates Monday through Friday, 7:30 am to 4:30 pm. The CCRC Infant/Toddler/Toddler Center is located on the left side, and Living Praise Early Learning Academy is on the right. During today’s inspection, LPA observed zero toddlers and zero infants during this inspection. There were 5 Teachers on the premises. Incidental Medical Services (IMS) were discussed. The center is clean, safe, sanitary, and in good repair; there are no potentially hazardous areas observed (passageways), floors are clean and safe, cleaning compounds are inaccessible, poisons are locked, furniture and equipment are in good condition, free of sharp, lose or pointed parts, including cribs, cots, changing table and feeding chairs, no insects or flies observed, play equipment are age appropriate. Each Infant/Toddler has its cubby, trash cans have tight-fitting lids, drinking water (individual cup-labeled), no toxic materials observed, no fireplace, and window screens in good repair. LPA observed the carbon monoxide, Fire Extinguisher, and smoke detector in working condition.

NAME OF LICENSING PROGRAM MANAGER: Mariela Ramon
NAME OF LICENSING PROGRAM ANALYST: Justeene Tamayo
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 09/26/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/26/2025

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: CCRC EHS LPC	FACILITY NUMBER: 197750009
	VISIT DATE: 09/26/2025

NARRATIVE

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There is a working telephone on the premises, an isolation area for ill Infant/Toddlers in the office area, room temperature is comfortable, First Aid Kit observed, sign-in/out observed (electronic), no smoking on the premises.
Physical Plant: No firearms on the premises. Disinfectants, cleaning solutions, poisons, and other items that are dangerous to Infants/toddlers are inaccessible (top cabinet) as well as under the sink with magnet locks. LPA observed that the fire extinguisher (2A10BC) and smoke detectors are in operable condition. The facility has one or more carbon monoxide detectors that meet statutory requirements. The changing table is within arm's reach of the sink.
Napping: LPA observed cots in a safe condition, cribs are in regulation (meets the requirements of 101439.1(a)-(f), no pillows, crib bumpers, loose bedding), sanitize after each use, cots spaced to have access to a safe walkway, bedding is not in contact with other bedding.
Restrooms: Each classroom has access to 1 bathroom, which contains 3 toilets and 2 sinks in each, and also has a diaper changing table within arm's reach of a sink. Staff bathrooms are in an adjacent building. LPA observed the bathrooms to be clean and sanitary, with soap, toilet paper, and paper towels readily available. The toilets and sinks are functioning properly.
Outdoor: There are 2 outside play yards. There is a swimming pool located in front of classrooms #1 and #2 with regulated 5 ft. fencing, which includes a spring closure on the gate. The Center has a shaded area and a playground free from hazards and debris, The play structure has cushion material (grass). The surface of the outdoor activity space is maintained in a safe condition and free of hazards. There is no high climbing equipment, swings, or slides on the premises for Infants/Toddlers. Play yard #1 (located in front of the center is only used for the preschool age children). Play yard #2 is located behind the center and is separated in sections for the infants and toddlers to use. Waiver on file for the toddler's and infants to use the same playground area at alternating times.

NAME OF LICENSING PROGRAM MANAGER: Mariela Ramon
NAME OF LICENSING PROGRAM ANALYST: Justeene Tamayo
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 09/26/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/26/2025

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: CCRC EHS LPC	FACILITY NUMBER: 197750009
	VISIT DATE: 09/26/2025

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Health-Related Services: Medications, when used, are inaccessible to children (locked in kitchen refrigerator); child name and date on medication; the parent has written consent as required. No children require IMS at this time.
Food Service: There are refrigerators located in each classroom; however, CCRC has its food program, which will deliver breakfast, lunch, and snacks daily. Some snacks will be kept on the premises.
Staff Records: LPA reviewed 3 files for staff.
Children Records: LPA observed that 5 children's files and the records were found to be in order.
Facility Records: LPA observed the Roster to be complete and current, and fire, and earthquake drills are conducted monthly. Last Fire/Disaster Drill was completed on 09/05/2025.

Advisory/Other: First Aid kit was observed with supplies (thermometer) readily available. Directors CPR/First Aid expires on 11/23/2026. Directors mandated reporter training expires on 08/17/2026.

The facility has an Infant/Toddler/Toddler individual feeding plan, an Infant/Toddler/Toddler Needs and Services Plan, and a Sleep Plan for each Infant/Toddler/Toddler.
Supervision: LPA observed that Infant/Toddler/Toddler/child is not left without the supervision (visual) of a teacher at any time, LPA observed that the facility complies with the staff-Infant/Toddler/Toddler ratio (one teacher-four Infant/Toddler/Toddlers in attendance).
Other: Telephone service, heating, lighting, and ventilation were evaluated.
· The isolation area for sick children is located in the Director’s office.
· A review of medication policy indicated that prescription medication is administered only with the parent's written permission. The Director and other administration staff administer medication and document the dosage, date, and time on a log. Medication is brought and taken home by the parents daily. Medication is properly labeled and stored in its original container.

NAME OF LICENSING PROGRAM MANAGER: Mariela Ramon
NAME OF LICENSING PROGRAM ANALYST: Justeene Tamayo
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 09/26/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/26/2025

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: CCRC EHS LPC	FACILITY NUMBER: 197750009
	VISIT DATE: 09/26/2025

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The incidental Medical Services (IMS) policy was discussed. For IMS information, see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. 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)/ (800) 514-0383 (TTY) and link to the publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm. The Center does not provide IMS at this time.
Mandated Reporter Training Requirements: §1596.8662 - As of January 1, 2018, childcare providers, administrators, or employees who work in a licensed facility shall complete the mandated reporter training provided according to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training.
Immunization Requirements: §1596.7995 (a)(1) Commencing September 1, 2016, a person shall not be employed or volunteer at a daycare center if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year.
All Licensing reports are available for review online and are considered public information. Summary: Assembly Bill 2621 added Section 1596.819 to the Health and Safety Code, to require the Department to post certain licensing information for CCCs and FCCHs on its public internet website.
Fingerprint clearances and transfers: Before working or volunteering in a licensed childcare facility, all individuals subject to a criminal record review shall obtain a clearance or criminal record exemption. If a fingerprint clearance has been obtained through the Department, Licensee may request a transfer of a criminal record clearance from one state-licensed facility to another using form LIC 9184

NAME OF LICENSING PROGRAM MANAGER: Mariela Ramon
NAME OF LICENSING PROGRAM ANALYST: Justeene Tamayo
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 09/26/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/26/2025

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: CCRC EHS LPC	FACILITY NUMBER: 197750009
	VISIT DATE: 09/26/2025

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Each report (documenting a Type A citation) shall remain posted for 30 days along with the Notice of Site Visit (printed out during this inspection). In addition; all parents of currently enrolled children and any newly enrolled child for the following 12 months shall receive a copy of the report documenting a Type A Citation and sign form LIC 9224 acknowledging receipt. Staff is aware of the required forms for children's files and forms that shall be posted after licensure.
Senate Bill AB 633 - Child Care Facilities: Parent Notification Requirements
Summary: This bill amends Health and Safety Code (HSC) sections 1596.859, 1596.8595, 1596.8895, and 1597.05 to improve the transparency of licensing records and to ensure that parents/guardians using a licensed childcare facility are aware of situations that present the greatest danger to children.
Parent Board contained all documents that are required to be posted according to Title 22 Regulations. Staff are certified in Pediatric CPR and First Aid. The in/out process was reviewed and observed. There is a fully stocked first aid kit available and a fully charged fire extinguisher and carbon monoxide detectors in place. The fire Drill/Earthquake log is posted.

No deficiencies are being cited at this time,however 1 technical violation was given.

Exit interview conducted with Director. A copy of this report is discussed and left with the Director, Rosa Ayala Lopez, along with her appeal rights and Notice of Site Visit.

NAME OF LICENSING PROGRAM MANAGER: Mariela Ramon
NAME OF LICENSING PROGRAM ANALYST: Justeene Tamayo
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 09/26/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/26/2025

LIC809 (FAS) - (06/04)

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