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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197750169
Report Date: 02/28/2025
Date Signed: 02/28/2025 01:03:10 PM

Document Has Been Signed on 02/28/2025 01:03 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 LPC HEAD STARTFACILITY NUMBER:
197750169
ADMINISTRATOR/
DIRECTOR:		BETTY ZAMORANO PEDREGONFACILITY TYPE:
850
ADDRESS:2320 EAST AVENUE RTELEPHONE:
(661) 273-0608
CITY:PALMDALESTATE: CAZIP CODE:
93550
CAPACITY: 64TOTAL ENROLLED CHILDREN: 64CENSUS: 0DATE:
02/28/2025
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:50 AM
MET WITH:Rosa Ayala Lopez, Director TIME VISIT/
INSPECTION COMPLETED:
01:10 PM
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On 02/28/2025 at 11:50AM Licensing Program Analyst (LPA) Justeene Tamayo met with Director, Rosa Ayala Lopez, who granted access to the facility. The purpose of the inspection was to conduct an unannounced case management inspection for a UIR received at Palmdale RO on 11/12/24 and updated UIR's received on 11/18/24 and 12/06/24. LPA disclosed the purpose of the inspection. Upon arrival, there were no preschool age children present at the time of inspection.

Description of incident: There was an initial closure of classrooms #5, #6, and #7 due to water leakage from the water heater. As of 11/18/24, the facility remained closed because of the water damage. A mold report was required for bathrooms #5 and #6, but classrooms #5,#6, #7 and bathroom #7 were unaffected by the water heater issue. On 12/06/24, the water heater was repaired, and the facility reopened on 12/09/24. However, bathrooms #5 and #6 still required repairs due to water damage. During this time, four alternative toilets were provided for use until repairs to bathrooms #5 and #6 were completed.

On 02/10/25, LPA Tamayo received the first completed mold report, dated 11/18/24, which confirmed the presence of mold on the ceiling of bathrooms #5 and #6. According to the Director, as of 02/24/25, repairs to both bathrooms had been completed, including the removal of mold. LPA inspected both bathrooms and found them to be in appropriate condition. LPA observed the ceiling tiles have been replaced, and the bathrooms have also been repainted. Mailman Environmental LLC, the mold remediation company, also visited the facility after the first initial mold report to verify that no mold remained after the repairs.



Please see LIC809-C for continuation page.
SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Justeene Tamayo
LICENSING EVALUATOR SIGNATURE: DATE: 02/28/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/28/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 2
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 LPC HEAD START
FACILITY NUMBER: 197750169
VISIT DATE: 02/28/2025
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 LPA Tamayo is currently awaiting the finalized mold report from the mold company to confirm that no mold is present. Once the finalized report is received, both bathrooms will be made available and accessible for use by the preschool-aged children. The Director has been instructed to send the finalized mold report via email.

An exit interview was conducted, and a copy of this report was read and provided to Director Rosa Ayala-Lopez, along with a copy of her appeal rights and Notice of Site Visit.
SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Justeene Tamayo
LICENSING EVALUATOR SIGNATURE:

DATE: 02/28/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/28/2025
LIC809 (FAS) - (06/04)
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