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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197750178
Report Date: 08/20/2026
Date Signed: 08/20/2026 02:20:36 PM

Document Has Been Signed on 08/20/2026 02:20 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:BOUQUET CANYON EARLY LEARNING ACADEMYFACILITY NUMBER:
197750178
ADMINISTRATOR/
DIRECTOR:		CHERYL CAMERONFACILITY TYPE:
860
ADDRESS:28110 WELLSTON DRIVETELEPHONE:
(661) 294-5300
CITY:SANTA CLARITASTATE: CAZIP CODE:
91350
CAPACITY: 48TOTAL ENROLLED CHILDREN: 42CENSUS: 2DATE:
08/20/2026
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:00 PM
MET WITH:Stephanie Fields, PrincipalTIME VISIT/
INSPECTION COMPLETED:
02:30 PM
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On Thursday, August 20, 2026, Licensing Program Analyst (LPA) Mayra Rivera conducted unannounced inspection at the facility and met with Principal, Stephanie Fields who guide LPA on a tour of the facility. The purpose of the inspection was to conduct an inspection for capacity increase. This facility is currently licensed for classrooms 23/24 and 25 for 48 preschool children. Facility is requesting to add classroom 18/19 for 24 preschool children for a total of 72. This facility is located on the grounds of Bouquet Canyon Elementary School, Saugus Union School District.

A fire clearance for capacity increase has been granted on August 17, 2026, for a total of 72 preschool children. Rooms 18, 19, 23, 24 and 25. Per fire inspector plans approved using an “E” occupancy. Classrooms 18/19 are combined in one and classrooms 23/24.

This is a preschool program half day AM/PM that serves children ages 3 to 4 years. This program operates Monday to Friday 8:30 a.m. – 11:30 a.m and Monday, Tuesday, and Thursday 12:30 pm-2:30 pm. Sign in and out takes place at the classrooms entrance area. All areas identified on the facility sketch were toured and inspected both indoors and outdoors. Teacher and child ratio were observed, and present staff are fingerprinted cleared and two staff are trained and have current pediatric first aid/CPR certification.

LPA Rivera entered classroom 18/19 to conduct an inspection and measurements. LPA observed 2 children and staff #1, staff #2 and staff #3 present providing care and supervision. LPA observed age-appropriate furniture and equipment to be in good condition, free of sharp, not loose, or pointed

Lady King
Mayra Rivera
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: BOUQUET CANYON EARLY LEARNING ACADEMY
FACILITY NUMBER: 197750178
VISIT DATE: 08/20/2026
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parts and age-appropriate toys accessible to children. LPA observed a cubby for children to store their personal belongings. LPA observed cleaning solutions stored inside the sink cabinet with a key lock making it inaccessible for children and open. LPA Rivera observed a trash bin with a lid.

Heating, lighting, and ventilation were evaluated by LPA Rivera. LPA observed central AC/heater and vents located on the ceiling. LPA observed the thermostat located in classroom and temperature to be 71 degrees. LPA observed carbon monoxide detectors in the classroom. LPA Rivera tested and heard the sounds, and they are operable.

LPA observed a total of 8 toilets in the girls bathroom, 4 urinals and 4 toilets in boys bathroom and a total of 8 handwashing sinks.

LPA Rivera entered the playground to conduct an inspection and measurements. LPA observed the yard to be fenced all around. LPA observed the side gates closed and lock with a self -latch. LPA observed age-appropriate play equipment and area to be in safe condition, free of sharp, no loose or pointed parts and free of hazards. LPA Rivera observed play structure equipment to be age appropriate and areas around or under high climbing equipment, are cushioned with granulated rubber mat that may absorb a fall. For outdoor drinking water, children bring out their water bottles. For adequate shade, LPA observed a post shade cover structure.

Principal was reminded that all adults 18 and over, including employees and volunteers, 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 up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

This facility provides Incidental Medical Services – IMS. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226.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 publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm.

NAME OF LICENSING PROGRAM MANAGER: Lady King
NAME OF LICENSING PROGRAM ANALYST: Mayra Rivera
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: BOUQUET CANYON EARLY LEARNING ACADEMY
FACILITY NUMBER: 197750178
VISIT DATE: 08/20/2026
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LPA advised the facility representative how to access forms, regulations, quarterly updates, and Provider Information Notices (PINs) on the Department website at: www.ccld.ca.gov.

Based on measurements taken during today's inspection and availability of toilets and sinks, the facility is equipped for the requested increase capacity of adding 24 preschoolers to bring to a total of 72 preschoolers.

No deficiencies were cited during today's inspection. A Notice of Site Visit (LIC 9213) was given and must remain posted for 30 days.

A license to operate a center for 72 preschoolers is effective today, 08/20/26. Exit interview conducted and report was reviewed with Principal Stephanie Fields.

NAME OF LICENSING PROGRAM MANAGER: Lady King
NAME OF LICENSING PROGRAM ANALYST: Mayra Rivera
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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