197750201-5-12-2026-12-CC-KCAY-DTZVSL-20260512164142

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197750201
Report Date: 05/12/2026
Date Signed: 05/12/2026 04:41:47 PM

Document Has Been Signed on 05/12/2026 04:41 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:	SUNSHINE DAY CAMP-VALENCIA VALLEY		FACILITY NUMBER:	197750201
ADMINISTRATOR/ DIRECTOR:	JAMIE POWELL		FACILITY TYPE:	860
ADDRESS:	23601 CARRIZO DRIVE		TELEPHONE:	(661) 254-2687
CITY:	VALENCIA	STATE: CA	ZIP CODE:	91355
CAPACITY: 120	TOTAL ENROLLED CHILDREN: 120	CENSUS: 55	DATE:	05/12/2026
TYPE OF VISIT:	Case Management - Incident	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	03:01 PM
MET WITH:	Jamie Powell		TIME VISIT/ INSPECTION COMPLETED:	04:55 PM

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On May 12, 2026, Licensing Program Analyst (LPA) Calloway, made an unannounced case management inspection to the above facility. The purpose of the case management was to follow up on a self-reported Unusual Incident Report (UIR) submitted to the Palmdale Regional Office on May 11, 2026. LPA met with Jamie Powell, the Program Director as the representative and toured the facility with the representative and observed fifty-five (55)-day care children and eleven staff in active care. All adults 18 years and over have Criminal Record Clearance (DOJ/FBI) and Child Abuse Central Index Clearance and are associated with the facility.

On May 5, 2026, the reported information involved Child 1 was playing in a soccer game on the grass field when they tripped and attempted to break their fall with their hands and injured their right arm.

LPA conducted interviews with relevant parties involved reviewed records, and completed a safety inspection of the playground. LPA obtained a copy of the staff roster and the child/parent roster.

Based on interviews, C1 was playing closely on the field with another child (Child 2) when they tripped over the soccer ball and tripped over each other and C1 landed on the ground using their hands to brace the fall and injured their right arm. The staff provided aid and notified the parent and C1 was taken to urgent care the same day. C1 was given a cast for the right arm and returned to the day care two days later. Based on interviews, the staff followed the proper protocol in providing aid and notified the parents and Community Care Licensing (CCL) within a timely manner.

There are no deficiencies cited during this inspection.

Exit interview was conducted, a copy of this report was read, a Notice of Site Visit, was given to Jamie Powell, at the facility. A Notice of Site Visit must remain posted for thirty (30) consecutive days. Failure to maintain posting may result in a $100 civil penalty.

NAME OF LICENSING PROGRAM MANAGER: Francisco Pedroza
NAME OF LICENSING PROGRAM ANALYST: Kuliema Calloway
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 05/12/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/12/2026

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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